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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23712.43,"10th_percentile":23712.43,"90th_percentile":23712.43,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8000.34,"maximum":17717.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12800.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9600.41,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17717.18},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15060.15},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16299.36},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11600.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16000.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8160.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11200.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10000.42,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10444.02,"maximum":24180.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16710.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12532.82,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24180.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20554.2},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22245.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15143.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20888.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10652.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14621.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13055.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11525.76,"maximum":27336.68,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11525.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18441.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13830.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27336.68},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11525.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23237.03},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25149.06},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16712.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11525.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23051.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11525.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11525.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11756.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11525.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16136.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14407.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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."}]}]},{"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":9214.3,"maximum":21422.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9214.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14742.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11057.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21422.92},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9214.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18210.15},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19708.55},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13360.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9214.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18428.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9214.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9214.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9214.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12900.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11517.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":578.35,"10th_percentile":578.35,"90th_percentile":578.35,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":37894.21,"10th_percentile":37894.21,"90th_percentile":37894.21,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22699.4,"10th_percentile":22699.4,"90th_percentile":22699.4,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":37897.63,"10th_percentile":37897.63,"90th_percentile":37897.63,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":34489.27,"10th_percentile":34489.27,"90th_percentile":36507.72,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":18985.13,"10th_percentile":18985.13,"90th_percentile":18985.13,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20008.69,"10th_percentile":20008.69,"90th_percentile":20008.69,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9576.71,"maximum":21774.85,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9576.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15322.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11492.05,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21774.85},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9576.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18509.3},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20032.32},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13886.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9576.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19153.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9576.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9576.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9768.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9576.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13407.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11970.89,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":44820.07,"10th_percentile":44820.07,"90th_percentile":44820.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10905.76,"maximum":26835.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10905.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17449.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13086.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26835.29},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10905.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22810.83},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24687.8},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15813.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10905.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10905.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10905.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11123.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10905.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15268.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13632.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8255.12,"10th_percentile":8255.12,"90th_percentile":8255.12,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13556.4,"10th_percentile":13556.4,"90th_percentile":13556.4,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6852.15,"maximum":16352.83,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10963.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8222.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16352.83},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13900.42},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15044.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9935.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13704.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6989.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9593.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8565.19,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6201.63,"10th_percentile":6201.63,"90th_percentile":6201.63,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":14168.89,"10th_percentile":14168.89,"90th_percentile":14168.89,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":14339.08,"10th_percentile":14339.08,"90th_percentile":14339.08,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9145.18,"10th_percentile":9145.18,"90th_percentile":9145.18,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6612.37,"10th_percentile":6612.37,"90th_percentile":6612.37,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8322.11,"10th_percentile":8322.11,"90th_percentile":8322.11,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7847.44,"10th_percentile":7847.44,"90th_percentile":7847.44,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4983.26,"maximum":11655.57,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4983.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7973.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5979.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11655.57},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4983.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9907.6},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10722.84},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7225.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4983.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9966.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4983.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4983.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5082.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4983.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6976.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6229.08,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4051.79,"10th_percentile":4051.79,"90th_percentile":4051.79,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":5021.79,"10th_percentile":5021.79,"90th_percentile":5021.79,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5865.02,"10th_percentile":5865.02,"90th_percentile":5865.02,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14651.77,"maximum":33931.81,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14651.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23442.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17582.12,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":33931.81},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14651.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28843.09},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31216.42},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21245.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14651.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29303.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14651.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14651.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14944.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14651.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20512.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18314.71,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18860.54,"10th_percentile":18860.54,"90th_percentile":18860.54,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18759.49,"10th_percentile":18759.49,"90th_percentile":18759.49,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":52909.62,"10th_percentile":52909.62,"90th_percentile":52909.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9682.04,"10th_percentile":9682.04,"90th_percentile":9682.04,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":70659.86,"10th_percentile":70659.86,"90th_percentile":70659.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10916.82,"10th_percentile":10916.82,"90th_percentile":10916.82,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6332.18,"maximum":14188.2,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10131.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7598.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14188.2},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12060.41},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13052.79},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9181.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6458.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8865.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7915.22,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12523.23,"maximum":29216.87,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20037.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15027.88,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29216.87},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24835.25},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26878.79},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18158.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25046.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12773.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17532.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15654.04,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":21253.43,"10th_percentile":21253.43,"90th_percentile":21253.43,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":76247.32,"10th_percentile":76247.32,"90th_percentile":76247.32,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13668.97,"10th_percentile":13668.97,"90th_percentile":16269.07,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16694.68,"10th_percentile":16694.68,"90th_percentile":16694.68,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":14688.37,"10th_percentile":7296.74,"90th_percentile":16284.47,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16694.68,"10th_percentile":16694.68,"90th_percentile":16694.68,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":45288.39,"10th_percentile":45288.39,"90th_percentile":70045.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8759.58,"10th_percentile":8759.58,"90th_percentile":8759.58,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16597.4,"10th_percentile":14889.69,"90th_percentile":20236.84,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14700.55,"10th_percentile":14699.8,"90th_percentile":15192.16,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14408.54,"10th_percentile":13840.47,"90th_percentile":16241.47,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6718.56,"maximum":15843.41,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10749.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8062.27,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15843.41},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13467.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14575.55},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9741.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13437.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9405.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8398.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":61454.54,"10th_percentile":61454.54,"90th_percentile":61454.54},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1826.18,"10th_percentile":1826.18,"90th_percentile":1826.18,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8442.76,"10th_percentile":6289.56,"90th_percentile":8851.27,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6282.44,"10th_percentile":6282.44,"90th_percentile":6282.44,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":17843.1,"10th_percentile":17843.1,"90th_percentile":20132.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13832.03,"10th_percentile":13832.03,"90th_percentile":13832.03,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":8780.39,"10th_percentile":7278.91,"90th_percentile":9314.07,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7971.25,"10th_percentile":7971.22,"90th_percentile":8150.42,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8445.43,"10th_percentile":8145.96,"90th_percentile":10643.93,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4318.73,"maximum":10230.16,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4318.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6909.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5182.48,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10230.16},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4318.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8695.96},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9411.49},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6262.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4318.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8637.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4318.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4318.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4405.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4318.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6046.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5398.41,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":4903.45,"10th_percentile":4903.45,"90th_percentile":4903.45,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":5808.21,"10th_percentile":5808.21,"90th_percentile":5808.21,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13442.61,"maximum":30923.5,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13442.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21508.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16131.13,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30923.5},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13442.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26285.94},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28448.85},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19491.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13442.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26885.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13442.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13442.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13711.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13442.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18819.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16803.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":17190.36,"10th_percentile":17190.36,"90th_percentile":17190.36,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16681.44,"10th_percentile":16681.44,"90th_percentile":16681.44,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7422.82,"maximum":17501.84,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11876.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8907.38,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17501.84},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14877.11},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16101.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10763.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14845.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7571.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10391.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9278.52,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":74798.46,"10th_percentile":74798.46,"90th_percentile":74798.46},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9640.43,"10th_percentile":9640.43,"90th_percentile":9640.43,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10308.37,"maximum":23931.44,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10308.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16493.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12370.04,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23931.44},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10308.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20342.47},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22016.33},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14947.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10308.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20616.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10308.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10308.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10514.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10308.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14431.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12885.46,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13795.72,"10th_percentile":13795.72,"90th_percentile":13795.72,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17694.2,"maximum":43299.01,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28310.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21233.04,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":43299.01},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":36805.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":39834.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25656.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35388.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18048.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24771.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22117.75,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13771.42,"10th_percentile":13771.42,"90th_percentile":13771.42,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13639.14,"10th_percentile":13639.14,"90th_percentile":13639.14,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14446.24,"maximum":33946.27,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23113.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17335.49,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":33946.27},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28855.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31229.72},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20947.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28892.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14735.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20224.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18057.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":18357.95,"10th_percentile":18357.95,"90th_percentile":18357.95,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":17611.28,"10th_percentile":17611.28,"90th_percentile":17611.28,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17078.41,"10th_percentile":17078.41,"90th_percentile":17078.41,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18767.48,"10th_percentile":18767.48,"90th_percentile":18767.48,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24463.46,"maximum":58236.07,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39141.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29356.15,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":58236.07},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":49502.47},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":53575.74},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35472.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48926.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24952.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34248.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30579.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":28974.05,"10th_percentile":28974.05,"90th_percentile":28974.05,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":71218.87,"10th_percentile":71218.87,"90th_percentile":71218.87,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29794.31,"10th_percentile":29794.31,"90th_percentile":29794.31,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11220.9,"maximum":26650.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11220.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17953.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13465.08,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26650.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11220.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22653.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24517.79},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16270.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11220.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22441.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11220.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11220.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11220.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15709.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14026.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":16045.9,"maximum":34150.36,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16045.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25673.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19255.08,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34150.36},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16045.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29028.87},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31417.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":23266.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16045.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32091.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16045.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16045.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16366.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16045.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22464.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20057.38,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16993.16,"10th_percentile":16993.16,"90th_percentile":16993.16,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24804.63,"maximum":55738.8,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24804.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39687.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29765.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":55738.8},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24804.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":47379.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":51278.3},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35966.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24804.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49609.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24804.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24804.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25300.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24804.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34726.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31005.79,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11529.18,"maximum":26531.57,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11529.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18446.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13835.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26531.57},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11529.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22552.66},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24408.38},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16717.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11529.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23058.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11529.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11529.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11759.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11529.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16140.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14411.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"1 through 10","median_amount":24093.36,"10th_percentile":24093.36,"90th_percentile":24093.36,"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":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25409.07,"10th_percentile":25409.07,"90th_percentile":25409.07,"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."}]}]},{"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":44882.22,"maximum":98955.85,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44882.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71811.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53858.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":98955.85},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44882.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":84115.55},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":91036.92},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":65079.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44882.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":89764.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44882.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44882.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45779.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44882.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62835.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56102.78,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7853.05,"maximum":18358.37,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7853.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12564.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9423.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18358.37},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7853.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15605.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16889.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11386.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7853.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15706.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7853.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7853.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8010.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7853.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10994.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9816.31,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10150.07,"10th_percentile":10150.07,"90th_percentile":10150.07,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10440.13,"10th_percentile":10440.13,"90th_percentile":10440.13,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9236.56,"10th_percentile":9236.56,"90th_percentile":9236.56,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11574.4,"maximum":26914.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11574.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18519.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13889.28,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26914.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11574.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22877.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24760.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16782.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11574.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23148.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11574.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11574.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11805.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11574.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16204.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14468.0,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8298.24,"10th_percentile":8298.24,"90th_percentile":8298.24,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":55456.07,"10th_percentile":55456.07,"90th_percentile":55456.07,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14911.26,"10th_percentile":14911.26,"90th_percentile":14911.26,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":14875.92,"10th_percentile":14875.92,"90th_percentile":14875.92,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9110.4,"10th_percentile":9110.4,"90th_percentile":9110.4,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14880.42,"10th_percentile":14880.42,"90th_percentile":14880.42,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":14875.92,"10th_percentile":14875.92,"90th_percentile":14875.92,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13537.09,"10th_percentile":13537.09,"90th_percentile":13537.09,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20148.84,"maximum":48377.13,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20148.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32238.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24178.61,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":48377.13},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20148.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":41122.06},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":44505.75},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":29215.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20148.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40297.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20148.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20148.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20551.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20148.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28208.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25186.05,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6646.76,"10th_percentile":6646.76,"90th_percentile":6646.76,"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."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6675.4,"maximum":16384.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6675.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10680.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8010.48,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16384.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6675.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13927.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15073.77},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9679.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6675.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13350.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6675.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6675.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6808.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6675.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9345.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8344.25,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9134.85,"10th_percentile":9134.85,"90th_percentile":9134.85,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":9294.89,"10th_percentile":9294.89,"90th_percentile":9294.89,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8244.5,"10th_percentile":8244.5,"90th_percentile":8244.5,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10574.87,"maximum":25217.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10574.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16919.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12689.84,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25217.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10574.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21435.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23199.05},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15333.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10574.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21149.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10574.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10574.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10786.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10574.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14804.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13218.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16747.4,"10th_percentile":16747.4,"90th_percentile":16747.4,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12687.32,"10th_percentile":12687.32,"90th_percentile":12687.32,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6134.88,"maximum":14361.76,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6134.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9815.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7361.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14361.76},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6134.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12207.94},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13212.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8895.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6134.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12269.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6134.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6134.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6257.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6134.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8588.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7668.6,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":7121.67,"10th_percentile":7121.67,"90th_percentile":7776.55,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":9537.52,"10th_percentile":9537.52,"90th_percentile":9537.52,"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":"VA Premier","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9760.99,"maximum":23521.66,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9760.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15617.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11713.19,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23521.66},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9760.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19994.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21639.34},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14153.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9760.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19521.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9760.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9760.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9956.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9760.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13665.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12201.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":13270.13,"10th_percentile":13270.13,"90th_percentile":13270.13},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":18538.63,"10th_percentile":18538.63,"90th_percentile":18538.63},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":30484.94,"10th_percentile":30484.94,"90th_percentile":30484.94,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":23647.55,"10th_percentile":22915.71,"90th_percentile":32965.87},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16665.97,"10th_percentile":12499.48,"90th_percentile":31795.61,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17733.24,"10th_percentile":15763.24,"90th_percentile":20845.15,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7714.67,"maximum":18300.52,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7714.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12343.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9257.6,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18300.52},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7714.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15556.01},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16836.02},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11186.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7714.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15429.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7714.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7714.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7868.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7714.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10800.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9643.34,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":20039.85,"10th_percentile":20039.85,"90th_percentile":20039.85},{"payer_name":"Aetna","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16253.92,"10th_percentile":9421.48,"90th_percentile":22743.69,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12776.02,"maximum":29827.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12776.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20441.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15331.22,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29827.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12776.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25354.33},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27440.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18525.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12776.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25552.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12776.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12776.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13031.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12776.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17886.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15970.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29830.74,"10th_percentile":29830.74,"90th_percentile":29830.74,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":55408.97,"10th_percentile":55408.97,"90th_percentile":55408.97,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":72378.98,"10th_percentile":72378.98,"90th_percentile":72378.98,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":30789.55,"10th_percentile":30789.55,"90th_percentile":30789.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":30527.65,"10th_percentile":30527.65,"90th_percentile":30527.65,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26029.89,"10th_percentile":26029.89,"90th_percentile":26029.89,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6119.12,"maximum":13881.27,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9790.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7342.94,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13881.27},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11799.51},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12770.42},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8872.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12238.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6241.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8566.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7648.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9531.83,"10th_percentile":9531.83,"90th_percentile":9625.48,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7674.74,"10th_percentile":7674.74,"90th_percentile":7674.74,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7674.74,"10th_percentile":7674.74,"90th_percentile":7674.74,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6984.01,"10th_percentile":6984.01,"90th_percentile":6984.01,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10186.43,"maximum":24903.68,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10186.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16298.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12223.72,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24903.68},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10186.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21168.9},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22910.76},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14770.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10186.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20372.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10186.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10186.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10390.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10186.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14261.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12733.04,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13889.25,"10th_percentile":13889.25,"90th_percentile":13889.25,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5690.26,"maximum":13121.16,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5690.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9104.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6828.31,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13121.16},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5690.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11153.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12071.14},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8250.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5690.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11380.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5690.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5690.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5804.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5690.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7966.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7112.82,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":8956.07,"10th_percentile":8956.07,"90th_percentile":8956.07},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7254.49,"10th_percentile":7254.49,"90th_percentile":7254.49,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9055.36,"maximum":21638.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14488.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10866.43,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21638.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18393.19},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19906.66},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13130.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18110.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9236.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12677.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11319.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5686.83,"maximum":13412.02,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5686.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9098.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6824.2,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13412.02},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5686.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11400.64},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12338.73},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8245.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5686.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11373.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5686.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5686.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5800.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5686.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7961.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7108.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10230.15,"10th_percentile":10230.15,"90th_percentile":10230.15,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49500.37,"10th_percentile":37984.66,"90th_percentile":118406.05,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21893.04,"10th_percentile":21893.04,"90th_percentile":21893.04,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20040.19,"10th_percentile":18527.07,"90th_percentile":21173.52,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23285.33,"10th_percentile":23285.33,"90th_percentile":23285.33,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":21051.03,"10th_percentile":19914.65,"90th_percentile":26535.69,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19111.03,"10th_percentile":19111.03,"90th_percentile":19381.88,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20390.07,"10th_percentile":20390.07,"90th_percentile":21114.27,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20139.61,"10th_percentile":20139.61,"90th_percentile":20139.61,"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."}]}]},{"description":"Major Small And Large Bowel Procedures With Mcc","code_information":[{"code":"329","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31489.62,"maximum":73788.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31489.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50383.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37787.54,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":73788.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31489.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":62722.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":67883.69},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":45659.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31489.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62979.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31489.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31489.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32119.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31489.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39362.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":52172.99,"10th_percentile":52172.99,"90th_percentile":52172.99},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39840.32,"10th_percentile":38584.69,"90th_percentile":50029.37,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":40798.37,"10th_percentile":40798.37,"90th_percentile":40798.37,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":40657.38,"10th_percentile":38543.17,"90th_percentile":47091.56,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":78171.57,"10th_percentile":78171.57,"90th_percentile":78171.57,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":38863.34,"10th_percentile":38863.34,"90th_percentile":38863.34},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":27800.97,"10th_percentile":27800.97,"90th_percentile":27800.97,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":40798.37,"10th_percentile":40798.37,"90th_percentile":40798.37,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22866.09,"10th_percentile":22866.09,"90th_percentile":22866.09,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":41939.65,"10th_percentile":41154.03,"90th_percentile":50889.46,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":37126.52,"10th_percentile":37125.05,"90th_percentile":38200.63,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38813.15,"10th_percentile":38813.15,"90th_percentile":38813.15,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10977.01,"maximum":25605.94,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10977.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17563.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13172.41,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25605.94},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10977.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21765.84},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23556.83},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15916.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10977.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21954.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10977.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10977.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11196.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10977.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15367.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13721.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":16744.68,"maximum":39019.57,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16744.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26791.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20093.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":39019.57},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16744.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":33167.85},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":35897.03},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":24279.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16744.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33489.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16744.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16744.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17079.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16744.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23442.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20930.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":45126.18,"10th_percentile":45126.18,"90th_percentile":45126.18,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":51264.15,"10th_percentile":51264.15,"90th_percentile":55016.9,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":43545.89,"10th_percentile":43545.89,"90th_percentile":43545.89,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":21993.75,"maximum":45992.34,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21993.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35190.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26392.5,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":45992.34},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21993.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39094.92},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":42311.81},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":31890.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21993.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43987.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21993.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21993.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22433.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21993.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30791.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27492.19,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":28545.56,"10th_percentile":28545.56,"90th_percentile":28545.56,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":29646.08,"maximum":68445.34,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29646.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47433.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35575.3,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":68445.34},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29646.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":58180.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":62968.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":42986.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29646.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59292.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29646.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29646.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30239.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29646.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41504.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37057.6,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12077.93,"maximum":29072.24,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19324.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14493.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29072.24},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24712.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26745.73},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17513.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24155.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12319.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16909.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15097.41,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":89269.1,"10th_percentile":89269.1,"90th_percentile":89269.1},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14467.03,"10th_percentile":14467.03,"90th_percentile":14490.94,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16161.46,"10th_percentile":16161.45,"90th_percentile":19134.55,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"21","median_amount":42765.82,"10th_percentile":36148.65,"90th_percentile":47361.24,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":40012.05,"10th_percentile":40012.05,"90th_percentile":40012.05},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16011.36,"10th_percentile":16011.36,"90th_percentile":16011.36,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16285.58,"10th_percentile":15283.58,"90th_percentile":18767.05,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20366.27,"10th_percentile":20366.27,"90th_percentile":20366.27,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":41688.74,"10th_percentile":41688.74,"90th_percentile":41688.74,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16074.48,"10th_percentile":16074.48,"90th_percentile":16074.48,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"22","median_amount":16054.58,"10th_percentile":15317.27,"90th_percentile":18193.75,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":79958.63,"10th_percentile":79958.63,"90th_percentile":97431.02},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16507.77,"10th_percentile":16507.77,"90th_percentile":16507.77,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16074.48,"10th_percentile":16074.48,"90th_percentile":16074.48,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15459.76,"10th_percentile":15459.76,"90th_percentile":15459.76,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15384.75,"10th_percentile":15384.75,"90th_percentile":15384.75,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":70095.04,"10th_percentile":70095.04,"90th_percentile":96808.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16074.48,"10th_percentile":16074.48,"90th_percentile":16074.48,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":16337.81,"10th_percentile":14858.99,"90th_percentile":16526.0,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":14627.78,"10th_percentile":14627.78,"90th_percentile":14651.97,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16074.48,"10th_percentile":15475.08,"90th_percentile":19134.55,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23092.93,"10th_percentile":23092.93,"90th_percentile":23092.93,"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."}]}]},{"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":18639.61,"maximum":45746.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29823.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22367.53,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":45746.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":38885.92},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":42085.61},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27027.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37279.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19012.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26095.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23299.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25489.77,"10th_percentile":25293.41,"90th_percentile":29529.95,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":95973.71,"10th_percentile":95973.71,"90th_percentile":95973.71},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16507.77,"10th_percentile":16507.77,"90th_percentile":16507.77,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":24848.4,"10th_percentile":24848.4,"90th_percentile":24848.4,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18840.93,"10th_percentile":18840.93,"90th_percentile":18840.93,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":92827.48,"10th_percentile":92827.48,"90th_percentile":92827.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":25293.41,"10th_percentile":25293.41,"90th_percentile":25293.41,"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":"1 through 10","median_amount":24350.67,"10th_percentile":24350.67,"90th_percentile":25203.27,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23017.0,"10th_percentile":23017.0,"90th_percentile":23017.0,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24841.68,"10th_percentile":24841.68,"90th_percentile":24841.68,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":16478.19,"maximum":37195.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26365.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19773.83,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":37195.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31617.44},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":34219.05},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":23893.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32956.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16807.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23069.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20597.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Passport Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":71542.32,"10th_percentile":71542.32,"90th_percentile":71542.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6065.69,"10th_percentile":6065.69,"90th_percentile":6065.69,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5519.0,"10th_percentile":5519.0,"90th_percentile":5519.0,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3915.16,"10th_percentile":3915.16,"90th_percentile":3915.16,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6599.36,"maximum":15464.16,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6599.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10558.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7919.23,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15464.16},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6599.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13145.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14226.64},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9569.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6599.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6599.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6599.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6731.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6599.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9239.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8249.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7378.62,"10th_percentile":7378.62,"90th_percentile":7378.62,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":8549.9,"10th_percentile":8237.44,"90th_percentile":10672.9,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7713.96,"10th_percentile":7713.96,"90th_percentile":7713.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4932.56,"maximum":11462.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7892.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5919.07,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11462.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9743.68},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10545.43},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7152.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9865.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5031.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6905.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6165.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5907.11,"10th_percentile":5907.11,"90th_percentile":7231.36,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4617.7,"10th_percentile":4617.7,"90th_percentile":4617.7,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":6078.66,"10th_percentile":6078.66,"90th_percentile":7431.76,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5768.0,"10th_percentile":5768.0,"90th_percentile":5821.36,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6379.61,"10th_percentile":6379.61,"90th_percentile":6379.61,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5971.14,"maximum":14001.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5971.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9553.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7165.37,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14001.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5971.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11901.96},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12881.3},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5971.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11942.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5971.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5971.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5971.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8359.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7463.92,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4808.56,"maximum":11224.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4808.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7693.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5770.27,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11224.9},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4808.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9541.51},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10326.62},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6972.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4808.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9617.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4808.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4808.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4904.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4808.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6731.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6010.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":6362.49,"10th_percentile":6362.49,"90th_percentile":6362.49,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":3878.23,"maximum":8991.17,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3878.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6205.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4653.88,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":8991.17},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3878.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":7642.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":8271.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":5623.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3878.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7756.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3878.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3878.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3955.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3878.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5429.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4847.79,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":4986.16,"10th_percentile":4768.68,"90th_percentile":4986.16,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8089.38,"10th_percentile":5681.53,"90th_percentile":9302.16,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4997.86,"10th_percentile":4997.86,"90th_percentile":4997.86,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4971.08,"10th_percentile":4971.08,"90th_percentile":4971.08,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4982.88,"10th_percentile":1471.7,"90th_percentile":5390.46,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4523.68,"10th_percentile":4523.68,"90th_percentile":4523.7,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5801.11,"10th_percentile":5801.11,"90th_percentile":5801.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6568.57,"10th_percentile":6568.57,"90th_percentile":6568.57,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":34610.98,"10th_percentile":34610.98,"90th_percentile":34610.98},{"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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10995.83,"10th_percentile":10995.83,"90th_percentile":10995.83,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8978.31,"10th_percentile":6619.17,"90th_percentile":10771.96,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10714.25,"10th_percentile":10714.25,"90th_percentile":10714.25,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":10987.41,"10th_percentile":10714.25,"90th_percentile":13328.86,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10006.2,"10th_percentile":10006.2,"90th_percentile":10006.2,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9742.96,"10th_percentile":9594.98,"90th_percentile":10920.29,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6256.13,"maximum":14885.64,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6256.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10009.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7507.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14885.64},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6256.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12653.26},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13694.42},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9071.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6256.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12512.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6256.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6256.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6381.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6256.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8758.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7820.16,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12106.81,"10th_percentile":12106.81,"90th_percentile":12106.81,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5173.03,"maximum":12063.75,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5173.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8276.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6207.64,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12063.75},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5173.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10254.56},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11098.35},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7500.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5173.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10346.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5173.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5173.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5276.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5173.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7242.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6466.29,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [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":12063.75,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":4544.77,"10th_percentile":4544.77,"90th_percentile":6447.75,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6669.86,"10th_percentile":6669.86,"90th_percentile":6669.86,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":268.31,"10th_percentile":268.31,"90th_percentile":8046.68,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6275.5,"10th_percentile":6275.5,"90th_percentile":6275.5,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6611.67,"10th_percentile":6611.67,"90th_percentile":11707.74,"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."}]}]},{"description":"Hypertension With Mcc","code_information":[{"code":"304","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8152.43,"maximum":18879.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13043.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9782.92,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18879.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16047.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17368.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11821.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16304.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8315.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11413.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10190.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":10252.35,"10th_percentile":10252.35,"90th_percentile":10470.09,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18818.53,"10th_percentile":18818.53,"90th_percentile":18818.53,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10400.59,"10th_percentile":10400.59,"90th_percentile":10400.59,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9553.37,"10th_percentile":9553.37,"90th_percentile":10494.17,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9889.85,"10th_percentile":9889.85,"90th_percentile":9889.85,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4611.95,"maximum":10805.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4611.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7379.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5534.34,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10805.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4611.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9184.98},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9940.76},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6687.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4611.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9223.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4611.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4611.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4704.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4611.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6456.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5764.94,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8197.65,"maximum":18692.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8197.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13116.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9837.18,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18692.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8197.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15889.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17196.75},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11886.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8197.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16395.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8197.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8197.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8361.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8197.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11476.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10247.06,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":4772.24,"10th_percentile":4772.24,"90th_percentile":4772.24,"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":"Magellan","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13155.98,"10th_percentile":13155.98,"90th_percentile":14339.67,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12627.39,"10th_percentile":12627.39,"90th_percentile":12627.39,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":37794.08,"10th_percentile":37794.08,"90th_percentile":37794.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":14738.57,"10th_percentile":14738.57,"90th_percentile":14738.57,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17020.36,"10th_percentile":17020.36,"90th_percentile":17020.36,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":3117.79,"maximum":7096.51,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3117.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4988.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":3741.35,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":7096.51},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3117.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":6032.26},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":6528.61},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":4520.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3117.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6235.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3117.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3117.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3180.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3117.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4364.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":3897.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10700.24,"maximum":26327.48,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10700.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17120.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12840.29,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26327.48},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10700.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22379.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24220.63},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15515.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10700.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21400.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10700.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10700.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10914.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10700.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14980.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13375.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14302.45,"10th_percentile":14302.45,"90th_percentile":14302.45,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14290.1,"10th_percentile":14290.1,"90th_percentile":14290.1,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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","minimum":10788.67,"maximum":12692.09,"payers_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12692.09},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10788.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11676.4}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5816.31,"maximum":13841.09,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5816.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9306.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6979.57,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13841.09},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5816.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11765.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12733.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8433.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5816.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11632.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5816.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5816.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5932.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5816.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8142.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7270.39,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7753.71,"10th_percentile":7753.71,"90th_percentile":7753.71,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7849.86,"10th_percentile":7849.86,"90th_percentile":7849.86,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10433.66,"10th_percentile":10433.66,"90th_percentile":10434.51,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"20","median_amount":11636.15,"10th_percentile":7691.67,"90th_percentile":12816.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"67","median_amount":11005.26,"10th_percentile":9330.96,"90th_percentile":11953.65,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11592.96,"10th_percentile":11592.96,"90th_percentile":11724.63,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6426.44,"10th_percentile":6426.44,"90th_percentile":6426.44,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":45379.7,"10th_percentile":45379.7,"90th_percentile":45379.7},{"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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11693.6,"maximum":25335.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18709.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14032.32,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25335.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21536.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23308.45},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16955.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23387.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11927.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16371.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14617.0,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12747.97,"10th_percentile":12747.97,"90th_percentile":12747.97,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18539.59,"maximum":43891.99,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18539.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29663.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22247.51,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":43891.99},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18539.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":37309.56},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":40379.54},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":26882.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18539.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37079.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18539.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18539.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18910.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18539.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25955.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23174.49,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":24268.99,"10th_percentile":24268.99,"90th_percentile":24268.99,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24457.38,"10th_percentile":24457.38,"90th_percentile":24457.38,"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":"Magellan","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":"Passport Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13905.7,"10th_percentile":13905.7,"90th_percentile":13905.7,"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."}]}]},{"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":15159.41,"maximum":35567.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24255.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18191.29,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":35567.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":30233.68},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":32721.43},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21981.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30318.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15462.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21223.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18949.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42561.54,"10th_percentile":35567.73,"90th_percentile":73045.46,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19735.78,"10th_percentile":18175.02,"90th_percentile":20109.29,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20208.96,"10th_percentile":20208.96,"90th_percentile":20208.96,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":19817.5,"10th_percentile":18006.79,"90th_percentile":20603.7,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":84957.93,"10th_percentile":84957.93,"90th_percentile":84957.93,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20208.96,"10th_percentile":20208.96,"90th_percentile":20208.96,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19724.55,"10th_percentile":19724.55,"90th_percentile":19724.55,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":87947.3,"10th_percentile":87947.3,"90th_percentile":87947.3},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12009.53,"10th_percentile":12009.53,"90th_percentile":12009.53,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17467.47,"10th_percentile":17467.47,"90th_percentile":17467.47,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17373.45,"10th_percentile":17373.45,"90th_percentile":17373.45,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16947.49,"10th_percentile":11701.32,"90th_percentile":17467.05,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17373.52,"10th_percentile":17373.52,"90th_percentile":17373.52,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16144.05,"10th_percentile":16144.05,"90th_percentile":16144.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6442.42,"10th_percentile":6442.42,"90th_percentile":6442.42,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6296.55,"maximum":14813.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6296.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10074.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7555.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14813.33},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6296.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12591.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13627.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9130.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6296.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12593.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6296.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6296.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6422.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6296.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8815.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7870.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14759.48,"10th_percentile":14759.48,"90th_percentile":14759.48,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8190.06,"10th_percentile":8190.06,"90th_percentile":8190.06,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"18","median_amount":8007.81,"10th_percentile":6352.59,"90th_percentile":8786.79,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":51760.67,"10th_percentile":51760.67,"90th_percentile":51760.67},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12889.11,"10th_percentile":12889.11,"90th_percentile":12889.11,"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":"Passport Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8209.51,"10th_percentile":8044.77,"90th_percentile":8567.54,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10989.34,"maximum":26378.91,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10989.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17582.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13187.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26378.91},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10989.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22422.89},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24267.94},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15934.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10989.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21978.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10989.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10989.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11209.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10989.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15385.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13736.68,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14583.6,"10th_percentile":14583.6,"90th_percentile":14583.6,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8430.56,"10th_percentile":8430.56,"90th_percentile":8430.56,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"21","median_amount":14440.92,"10th_percentile":5036.05,"90th_percentile":17179.96,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13271.08,"10th_percentile":10669.41,"90th_percentile":15616.03,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14583.6,"10th_percentile":13290.17,"90th_percentile":17394.9,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24706.66,"maximum":51491.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24706.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39530.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29647.99,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":51491.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24706.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":43769.37},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":47370.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35824.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24706.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49413.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24706.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24706.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25200.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24706.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34589.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30883.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":38132.82,"maximum":80396.6,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38132.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61012.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45759.38,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":80396.6},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38132.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":68339.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":73962.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":55292.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38132.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":76265.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38132.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38132.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38895.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38132.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53385.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47666.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":214991.0,"10th_percentile":214991.0,"90th_percentile":214991.0,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":48848.82,"maximum":113558.66,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48848.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78158.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58618.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":113558.66},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48848.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":96528.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":104471.14},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":70830.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48848.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":97697.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48848.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48848.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49825.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48848.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68388.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61061.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":52860.14,"10th_percentile":52860.14,"90th_percentile":52860.14,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"28","median_amount":27883.64,"10th_percentile":27479.4,"90th_percentile":35499.78,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":27729.64,"10th_percentile":27729.64,"90th_percentile":27729.64,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":28440.61,"10th_percentile":27795.52,"90th_percentile":36440.7,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":26614.12,"10th_percentile":26614.12,"90th_percentile":27356.68,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27626.4,"10th_percentile":27601.9,"90th_percentile":29997.07,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":28262.9,"maximum":62833.7,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33915.48,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":62833.7},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":53410.6},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":57805.44},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":40981.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56525.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28828.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39568.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35328.62,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":35628.22,"10th_percentile":35628.22,"90th_percentile":35628.22,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34929.62,"10th_percentile":34929.62,"90th_percentile":34929.62,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17490.05,"maximum":40207.14,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17490.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27984.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20988.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":40207.14},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17490.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":34177.32},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":36989.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25360.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17490.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34980.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17490.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17490.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17839.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17490.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24486.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21862.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24363.44,"maximum":55351.51,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24363.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38981.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29236.13,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":55351.51},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24363.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":47050.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":50922.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35326.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24363.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48726.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24363.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24363.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24850.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24363.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34108.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30454.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":30603.13,"10th_percentile":30603.13,"90th_percentile":30603.13,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33421.56,"10th_percentile":33421.56,"90th_percentile":33421.56,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":29555.73,"10th_percentile":29555.73,"90th_percentile":29555.73,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30675.71,"10th_percentile":30675.71,"90th_percentile":30675.71,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":36146.78,"maximum":82484.1,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36146.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57834.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43376.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":82484.1},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36146.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":70114.05},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":75883.32},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":52412.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36146.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72293.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36146.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36146.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36869.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36146.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50605.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45183.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":45605.97,"10th_percentile":45605.97,"90th_percentile":45605.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21694.28,"10th_percentile":21694.28,"90th_percentile":21694.28,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":45851.66,"10th_percentile":45605.97,"90th_percentile":46171.42,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":45222.04,"10th_percentile":43257.34,"90th_percentile":47289.07,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":45605.97,"10th_percentile":45605.97,"90th_percentile":45605.97,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":101108.43,"10th_percentile":101108.43,"90th_percentile":101108.43,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":28932.22,"maximum":66857.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28932.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46291.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34718.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":66857.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28932.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":56831.06},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":61507.35},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":41951.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28932.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57864.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28932.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28932.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29510.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28932.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40505.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36165.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":36822.99,"10th_percentile":36822.99,"90th_percentile":37170.99,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":41527.32,"10th_percentile":41527.32,"90th_percentile":41527.32},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":33640.17,"10th_percentile":33640.17,"90th_percentile":33640.17,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":47119.0,"maximum":107141.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47119.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75390.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56542.8,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":107141.9},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47119.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":91073.95},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":98567.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":68322.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47119.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94238.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47119.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47119.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48061.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47119.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65966.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58898.75,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":32615.2,"maximum":75599.71,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52184.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39138.24,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":75599.71},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":64262.1},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":69549.85},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":47292.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65230.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33267.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45661.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40769.0,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":37620.52,"10th_percentile":37620.52,"90th_percentile":37620.52,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":51675.91,"10th_percentile":51675.91,"90th_percentile":51675.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":169384.85,"10th_percentile":169384.85,"90th_percentile":169384.85,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":53353.84,"10th_percentile":53353.84,"90th_percentile":53353.84,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24787.5,"maximum":57320.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24787.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39660.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29745.0,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":57320.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24787.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":48723.85},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":52733.05},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35941.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24787.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49575.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24787.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24787.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25283.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24787.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34702.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30984.38,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":28888.35,"10th_percentile":28888.35,"90th_percentile":30608.52,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":30223.27,"10th_percentile":30223.27,"90th_percentile":30223.27,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31294.52,"10th_percentile":31294.52,"90th_percentile":31294.52,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20945.58,"maximum":43098.13,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20945.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33512.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25134.7,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":43098.13},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20945.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":36634.75},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":39649.21},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":30371.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20945.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41891.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20945.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20945.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21364.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20945.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29323.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26181.98,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11166.09,"maximum":24389.44,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11166.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17865.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13399.31,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24389.44},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11166.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20731.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22437.68},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16190.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11166.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22332.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11166.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11166.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11389.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11166.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15632.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13957.61,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":12656.09,"10th_percentile":12656.09,"90th_percentile":12656.09,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12951.4,"maximum":30491.22,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12951.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20722.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15541.68,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30491.22},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12951.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25918.48},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28051.16},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18779.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12951.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25902.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12951.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12951.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13210.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12951.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18131.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16189.25,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":17308.78,"10th_percentile":17308.78,"90th_percentile":17308.78,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":22284.22,"maximum":54747.28,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22284.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35654.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26741.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":54747.28},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22284.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":46536.89},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":50366.13},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":32312.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22284.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44568.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22284.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22284.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22729.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22284.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31197.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27855.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49596.73,"10th_percentile":49596.73,"90th_percentile":49596.73,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":71.89,"10th_percentile":71.89,"90th_percentile":71.89,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13852.97,"maximum":28244.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13852.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22164.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16623.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28244.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13852.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24008.82},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25984.36},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20086.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13852.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27705.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13852.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13852.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14130.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13852.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19394.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17316.21,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12206.04,"maximum":28111.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12206.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19529.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14647.25,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28111.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12206.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23895.44},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25861.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17698.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12206.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24412.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12206.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12206.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12450.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12206.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17088.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15257.55,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49137.08,"10th_percentile":49137.08,"90th_percentile":49137.08,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17781.89,"maximum":41025.1,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17781.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28451.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21338.27,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":41025.1},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17781.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":34872.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":37742.07},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25783.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17781.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35563.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17781.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17781.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18137.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17781.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24894.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22227.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13625.44,"10th_percentile":13625.44,"90th_percentile":13625.44,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22682.25,"10th_percentile":22682.25,"90th_percentile":22682.25,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22683.05,"10th_percentile":22683.05,"90th_percentile":22683.05,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20923.63,"10th_percentile":20923.63,"90th_percentile":22287.93,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13876.95,"10th_percentile":13876.95,"90th_percentile":13876.95,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":32920.3,"10th_percentile":32920.3,"90th_percentile":32920.3},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":22600.23,"10th_percentile":22600.23,"90th_percentile":22600.23,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":23897.58,"maximum":55123.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23897.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38236.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28677.1,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":55123.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23897.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":46856.53},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":50712.08},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":34651.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23897.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47795.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23897.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23897.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24375.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23897.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33456.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29871.98,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":56634.09,"10th_percentile":56634.09,"90th_percentile":56634.09,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":30642.8,"10th_percentile":29886.27,"90th_percentile":31718.63,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":30169.54,"10th_percentile":30169.54,"90th_percentile":30169.54,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36051.25,"10th_percentile":36051.25,"90th_percentile":36051.25,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37859.94,"10th_percentile":37859.94,"90th_percentile":37859.94,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10238.49,"maximum":25109.38,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10238.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16381.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12286.19,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25109.38},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10238.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21343.75},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23100.0},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14845.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10238.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20476.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10238.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10238.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10443.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10238.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14333.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12798.11,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":56664.1,"10th_percentile":56664.1,"90th_percentile":56664.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13883.48,"10th_percentile":13883.48,"90th_percentile":13883.48,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14951.83,"maximum":37165.09,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23922.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17942.2,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":37165.09},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31591.48},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":34190.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21680.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29903.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15250.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20932.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18689.79,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":20500.68,"10th_percentile":20500.68,"90th_percentile":20500.68,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16998.87,"10th_percentile":16998.87,"90th_percentile":16998.87,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aicd Generator Procedures","code_information":[{"code":"245","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31256.01,"maximum":78526.06,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31256.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50009.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37507.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":78526.06},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31256.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":66749.59},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":72242.02},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":45321.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31256.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62512.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31256.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31256.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31881.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31256.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43758.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39070.01,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42040.56,"10th_percentile":42040.56,"90th_percentile":42040.56,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12382.79,"maximum":29001.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12382.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19812.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14859.35,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29001.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12382.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24652.2},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26680.68},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17955.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12382.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24765.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12382.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12382.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12382.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17335.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15478.49,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16819.37,"10th_percentile":16819.37,"90th_percentile":16819.37,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":30981.39,"10th_percentile":29851.85,"90th_percentile":31569.89,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30209.03,"10th_percentile":30209.03,"90th_percentile":30209.03,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9484.22,"maximum":24262.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9484.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15174.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11381.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24262.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9484.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20623.87},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22320.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13752.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9484.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18968.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9484.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9484.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9673.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9484.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13277.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11855.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":19528.16,"maximum":46795.84,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19528.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31245.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23433.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":46795.84},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19528.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39777.92},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":43051.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":28315.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19528.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39056.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19528.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19528.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19918.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19528.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27339.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24410.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":26135.38,"10th_percentile":26135.38,"90th_percentile":26135.38,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26013.86,"10th_percentile":26013.86,"90th_percentile":26013.86,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":24004.23,"10th_percentile":24004.23,"90th_percentile":24004.23,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9578.9,"10th_percentile":9578.9,"90th_percentile":9578.9,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":33717.5,"maximum":80936.56,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33717.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53948.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40461.0,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":80936.56},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33717.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":68798.59},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":74459.62},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":48890.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33717.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67435.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33717.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33717.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34391.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33717.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42146.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":28696.56,"maximum":66076.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28696.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45914.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34435.87,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":66076.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28696.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":56167.19},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":60788.85},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":41610.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28696.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57393.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28696.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28696.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29270.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28696.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40175.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35870.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":32881.87,"10th_percentile":32881.87,"90th_percentile":43266.52,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44292.24,"10th_percentile":36646.31,"90th_percentile":45462.76,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36532.91,"10th_percentile":36532.91,"90th_percentile":36532.91,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":66554.42,"10th_percentile":47575.45,"90th_percentile":80415.48,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":50029.05,"10th_percentile":50029.05,"90th_percentile":50029.05},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":36732.24,"10th_percentile":34894.74,"90th_percentile":44301.47,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36535.42,"10th_percentile":36535.42,"90th_percentile":38255.28,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":36396.79,"10th_percentile":34844.93,"90th_percentile":36872.04,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":111214.33,"10th_percentile":111214.33,"90th_percentile":111214.33},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":35533.44,"10th_percentile":35533.44,"90th_percentile":35533.44,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36535.42,"10th_percentile":36535.42,"90th_percentile":36535.42,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":32957.55,"10th_percentile":32957.55,"90th_percentile":32957.55,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":38255.28,"10th_percentile":38255.28,"90th_percentile":38255.28,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":36950.06,"10th_percentile":35879.29,"90th_percentile":38474.29,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":33247.23,"10th_percentile":33244.95,"90th_percentile":33867.37,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35545.04,"10th_percentile":35545.04,"90th_percentile":36847.04,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":40204.5,"maximum":94552.67,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64327.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48245.4,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":94552.67},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":80372.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":86986.1},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":58296.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":80409.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41008.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40204.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56286.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50255.62,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":61993.1,"10th_percentile":61993.1,"90th_percentile":61993.1,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":52280.27,"10th_percentile":52280.27,"90th_percentile":52280.27,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36620.92,"10th_percentile":36620.92,"90th_percentile":36620.92,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":52280.27,"10th_percentile":51868.75,"90th_percentile":64968.19,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":47575.05,"10th_percentile":47575.05,"90th_percentile":48772.81,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":50838.74,"10th_percentile":50838.74,"90th_percentile":50838.74,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":37423.77,"maximum":85490.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37423.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59878.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44908.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":85490.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37423.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":72669.83},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":78649.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":54264.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37423.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74847.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37423.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37423.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38172.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37423.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52393.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46779.71,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":47636.17,"10th_percentile":45311.49,"90th_percentile":50904.13,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36252.09,"10th_percentile":36252.09,"90th_percentile":36252.09,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":137836.7,"10th_percentile":137836.7,"90th_percentile":137836.7},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":52375.6,"maximum":125599.91,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52375.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83800.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62850.72,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":125599.91},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52375.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":106763.83},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":115548.79},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":75944.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52375.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":104751.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52375.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52375.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53423.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52375.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73325.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65469.5,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":69442.56,"10th_percentile":69442.56,"90th_percentile":69442.56,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69986.7,"10th_percentile":67982.94,"90th_percentile":132721.01,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":285860.24,"10th_percentile":285860.24,"90th_percentile":285860.24},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":69668.13,"10th_percentile":69512.95,"90th_percentile":84440.01,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":63537.78,"10th_percentile":63537.78,"90th_percentile":63537.78,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69447.58,"10th_percentile":69447.58,"90th_percentile":69447.58,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":41533.55,"maximum":98160.38,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41533.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66453.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49840.26,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":98160.38},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41533.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":83439.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":90305.11},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":60223.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41533.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83067.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41533.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41533.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42364.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41533.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58146.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51916.94,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":124965.32,"10th_percentile":124965.32,"90th_percentile":124965.32,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":21576.54,"maximum":49915.03,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21576.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34522.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25891.85,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":49915.03},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21576.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":42429.33},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":45920.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":31285.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21576.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43153.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21576.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21576.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22008.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21576.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30207.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26970.68,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":72876.54,"10th_percentile":72876.54,"90th_percentile":72876.54},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":34866.47,"10th_percentile":34866.47,"90th_percentile":34866.47,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":25115.12,"10th_percentile":25115.12,"90th_percentile":25115.12,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":33893.56,"maximum":80075.2,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33893.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54229.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40672.27,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":80075.2},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33893.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":68066.41},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":73667.19},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":49145.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33893.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67787.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33893.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33893.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34571.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33893.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47450.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42366.95,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":141688.44,"10th_percentile":141688.44,"90th_percentile":141688.44},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":36533.85,"maximum":85111.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36533.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58454.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43840.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":85111.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36533.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":72347.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":78300.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":52974.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36533.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73067.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36533.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36533.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36533.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51147.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45667.31,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":59861.99,"10th_percentile":59861.99,"90th_percentile":59861.99,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":75705.41,"10th_percentile":75705.41,"90th_percentile":75705.41,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":42416.92,"10th_percentile":42416.92,"90th_percentile":42416.92,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":123899.77,"10th_percentile":123899.77,"90th_percentile":123899.77,"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":"VA Premier","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":45045.95,"maximum":95602.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72073.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54055.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":95602.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":81264.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":87951.49},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":65316.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":90091.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45946.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63064.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56307.44,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":54199.89,"10th_percentile":54199.89,"90th_percentile":54199.89,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Heart Assist System Implant","code_information":[{"code":"215","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":68213.24,"maximum":170248.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68213.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":109141.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81855.89,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":170248.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68213.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":144716.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":156624.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":98909.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68213.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":136426.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68213.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68213.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":69577.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68213.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95498.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85266.55,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":22675.12,"10th_percentile":18259.12,"90th_percentile":25337.72,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":25103.2,"10th_percentile":25103.2,"90th_percentile":25103.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":165466.15,"10th_percentile":165466.15,"90th_percentile":165466.15},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23393.41,"10th_percentile":22043.04,"90th_percentile":24030.28,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":44082.73,"maximum":103935.94,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44082.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70532.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52899.28,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":103935.94},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44082.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":88348.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":95618.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":63919.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44082.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88165.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44082.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44082.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44964.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44082.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61715.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55103.41,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":51714.13,"10th_percentile":51714.13,"90th_percentile":51714.13,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":57130.15,"10th_percentile":57130.15,"90th_percentile":57460.14,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":57596.64,"10th_percentile":56450.3,"90th_percentile":57906.2,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":57460.14,"10th_percentile":57460.14,"90th_percentile":58766.54,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":57917.37,"10th_percentile":57917.37,"90th_percentile":57917.37,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":57460.14,"10th_percentile":57460.14,"90th_percentile":57460.14,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":57460.14,"10th_percentile":57460.14,"90th_percentile":57460.14,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":59019.86,"10th_percentile":59019.86,"90th_percentile":59019.86,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":53477.55,"10th_percentile":53477.55,"90th_percentile":53477.55,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6447.27,"maximum":14556.21,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6447.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10315.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7736.72,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14556.21},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6447.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12373.23},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13391.35},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9348.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6447.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12894.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6447.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6447.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6576.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6447.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9026.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8059.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6719.25,"10th_percentile":6719.25,"90th_percentile":6719.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4590.02,"maximum":11189.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4590.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7344.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5508.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11189.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4590.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9511.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10294.1},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6655.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4590.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9180.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4590.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4590.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4681.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4590.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6426.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5737.52,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6653.48,"maximum":15534.87,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10645.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7984.18,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15534.87},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13205.12},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14291.69},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9647.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13306.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6786.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9314.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8316.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8588.99,"10th_percentile":8588.99,"90th_percentile":8869.73,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7836.38,"10th_percentile":7259.17,"90th_percentile":7984.58,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8589.03,"10th_percentile":8589.03,"90th_percentile":8589.03,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8588.99,"10th_percentile":8588.99,"90th_percentile":8588.99,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7816.02,"10th_percentile":7815.98,"90th_percentile":8071.45,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4898.99,"maximum":10877.78,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4898.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7838.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5878.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10877.78},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4898.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9246.45},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10007.29},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7103.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4898.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9797.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4898.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4898.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4996.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4898.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6858.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6123.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4769.04,"10th_percentile":4769.04,"90th_percentile":4769.04,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5166.35,"10th_percentile":5166.35,"90th_percentile":5166.35,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7531.07,"maximum":17795.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12049.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9037.28,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17795.92},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15127.08},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16371.8},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10920.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15062.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7681.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10543.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9413.84,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":6057.56,"10th_percentile":6057.56,"90th_percentile":6057.56,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9839.98,"10th_percentile":9839.98,"90th_percentile":9839.98,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9839.98,"10th_percentile":9839.98,"90th_percentile":9839.98,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8489.95,"10th_percentile":7980.86,"90th_percentile":9894.99,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":9839.98,"10th_percentile":9839.98,"90th_percentile":9839.98},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9839.98,"10th_percentile":9839.98,"90th_percentile":9839.98,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10116.37,"10th_percentile":10116.37,"90th_percentile":10116.37,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8954.38,"10th_percentile":8954.38,"90th_percentile":8954.38,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9260.19,"10th_percentile":9260.19,"90th_percentile":9260.19,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12085.47,"maximum":28366.76,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19336.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14502.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28366.76},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24112.63},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26096.72},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24170.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12327.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12085.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16919.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15106.84,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15684.44,"10th_percentile":15684.44,"90th_percentile":15684.44,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":16125.58,"10th_percentile":16125.58,"90th_percentile":16125.58,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14272.84,"10th_percentile":14272.84,"90th_percentile":14272.84,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4906.53,"maximum":11255.43,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4906.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7850.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5887.84,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11255.43},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4906.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9567.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10354.71},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7114.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4906.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9813.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4906.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4906.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5004.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4906.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6869.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6133.16,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10148.43,"10th_percentile":10148.43,"90th_percentile":10148.43,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16740.92,"10th_percentile":16740.92,"90th_percentile":16740.92,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4305.72,"maximum":10008.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4305.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6889.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5166.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10008.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4305.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8507.45},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9207.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6243.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4305.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8611.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4305.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4305.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4391.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4305.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6028.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5382.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7285.59,"10th_percentile":7285.59,"90th_percentile":7285.59,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11707.57,"10th_percentile":11707.57,"90th_percentile":11707.57,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":21175.44,"10th_percentile":16634.43,"90th_percentile":21598.22,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"20","median_amount":11735.38,"10th_percentile":9479.99,"90th_percentile":14265.72,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11707.57,"10th_percentile":11707.57,"90th_percentile":12004.1,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"57","median_amount":9862.95,"10th_percentile":6431.43,"90th_percentile":11770.65,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":14535.67,"10th_percentile":14535.67,"90th_percentile":14535.67},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9836.37,"10th_percentile":9836.37,"90th_percentile":9836.37,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11707.57,"10th_percentile":7285.59,"90th_percentile":12004.1,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6423.09,"10th_percentile":6423.09,"90th_percentile":6423.09,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":16424.7,"10th_percentile":16424.7,"90th_percentile":16424.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7285.59,"10th_percentile":7285.59,"90th_percentile":7285.59,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"36","median_amount":10740.44,"10th_percentile":6452.65,"90th_percentile":12668.24,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":10653.89,"10th_percentile":10004.69,"90th_percentile":10654.74,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":10564.63,"10th_percentile":7289.56,"90th_percentile":11897.15,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16815.19,"10th_percentile":16815.19,"90th_percentile":16815.19,"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."}]}]},{"description":"Chronic Obstructive Pulmonary Disease Without Cc/Mcc","code_information":[{"code":"192","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4398.2,"maximum":10400.5,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4398.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7037.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5277.84,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10400.5},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4398.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8840.75},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9568.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6377.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4398.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8796.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4398.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4398.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4486.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4398.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6157.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5497.75,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":27524.4,"10th_percentile":27524.4,"90th_percentile":27524.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":4588.58,"10th_percentile":4588.58,"90th_percentile":4588.58,"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":"VA Premier","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7588.61,"maximum":18051.43,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7588.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12141.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9106.33,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18051.43},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7588.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15344.28},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16606.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11003.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7588.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15177.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7588.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7588.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7588.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10624.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9485.76,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9977.7,"10th_percentile":8515.4,"90th_percentile":10039.28,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":12299.84,"10th_percentile":12299.84,"90th_percentile":12299.84},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10116.35,"10th_percentile":10116.35,"90th_percentile":10116.35,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9977.69,"10th_percentile":9977.69,"90th_percentile":9977.69,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9766.64,"10th_percentile":8464.03,"90th_percentile":10232.09,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":9079.7,"10th_percentile":6946.01,"90th_percentile":9205.88,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8938.09,"10th_percentile":8150.17,"90th_percentile":10313.95,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17174.71,"10th_percentile":17174.71,"90th_percentile":17174.71,"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."}]}]},{"description":"Pulmonary Edema And Respiratory Failure","code_information":[{"code":"189","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8463.46,"maximum":19886.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13541.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10156.15,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19886.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16904.25},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18295.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12272.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16926.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8632.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11848.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10579.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8494.91,"10th_percentile":8494.91,"90th_percentile":8494.91,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"27","median_amount":11020.24,"10th_percentile":8480.84,"90th_percentile":11130.43,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":10994.12,"10th_percentile":6282.36,"90th_percentile":11282.61,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"21","median_amount":9887.14,"10th_percentile":6742.73,"90th_percentile":10981.46,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":4424.59,"10th_percentile":4424.59,"90th_percentile":4424.59},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14477.18,"10th_percentile":14477.18,"90th_percentile":14477.18,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10994.12,"10th_percentile":10994.12,"90th_percentile":10994.12,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5323.5,"10th_percentile":5323.5,"90th_percentile":5323.5,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5323.49,"10th_percentile":5323.49,"90th_percentile":5323.49,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":24457.59,"10th_percentile":24457.59,"90th_percentile":24457.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8588.99,"10th_percentile":7632.98,"90th_percentile":10994.12,"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":"15","median_amount":9686.81,"10th_percentile":6349.99,"90th_percentile":12088.87,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"31","median_amount":10004.65,"10th_percentile":5632.16,"90th_percentile":10005.5,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9818.13,"10th_percentile":9289.34,"90th_percentile":11502.99,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13396.87,"10th_percentile":13396.87,"90th_percentile":13396.87,"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."}]}]},{"description":"Pleural Effusion Without Cc/Mcc","code_information":[{"code":"188","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4913.38,"maximum":11796.99,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4913.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7861.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5896.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11796.99},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4913.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10027.81},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10852.93},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7124.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4913.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9826.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4913.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4913.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5011.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4913.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6878.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6141.72,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":48433.35,"10th_percentile":48433.35,"90th_percentile":48433.35,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6776.11,"maximum":16132.67,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10841.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8131.33,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16132.67},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13713.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14841.66},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9825.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13552.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6911.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9486.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8470.14,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":6614.45,"10th_percentile":6614.45,"90th_percentile":6614.45,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8967.07,"10th_percentile":8967.07,"90th_percentile":8967.07,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10676.94,"maximum":25390.6,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17083.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12812.33,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25390.6},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21582.8},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23358.72},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15481.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21353.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10890.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14947.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13346.18,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":7640.59,"10th_percentile":7640.59,"90th_percentile":7640.59},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6536.46,"10th_percentile":6536.46,"90th_percentile":6536.46,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7289.92,"maximum":17162.76,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7289.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11663.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8747.9,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17162.76},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7289.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14588.88},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15789.31},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10570.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7289.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14579.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7289.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7289.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7435.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7289.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10205.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9112.4,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10481.01,"maximum":25506.3,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10481.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16769.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12577.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25506.3},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10481.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21681.15},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23465.16},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15197.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10481.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20962.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10481.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10481.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10690.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10481.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14673.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13101.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24991.99,"10th_percentile":24991.99,"90th_percentile":24991.99,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14037.99,"10th_percentile":14037.99,"90th_percentile":14037.99,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":14178.9,"10th_percentile":11986.03,"90th_percentile":17555.79,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Passport Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15649.61,"10th_percentile":15649.61,"90th_percentile":15649.61,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5172.34,"maximum":12369.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8275.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6206.81,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12369.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10514.1},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11379.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7499.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10344.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5275.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7241.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6465.42,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8635.78,"10th_percentile":8635.78,"90th_percentile":8862.16,"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":"Magellan","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":"Passport Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10705.72,"maximum":25977.16,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10705.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17129.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12846.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25977.16},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10705.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22081.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23898.34},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15523.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10705.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21411.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10705.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10705.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10919.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10705.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14988.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13382.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6374.04,"10th_percentile":5864.5,"90th_percentile":8737.0,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7236.71,"10th_percentile":7236.71,"90th_percentile":7236.71,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":7150.57,"10th_percentile":7150.57,"90th_percentile":7150.57,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7275.7,"10th_percentile":7275.7,"90th_percentile":7275.7,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9410.23,"maximum":22644.24,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15056.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11292.28,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22644.24},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19248.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20832.13},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13644.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18820.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9598.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13174.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11762.79,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10765.06,"10th_percentile":10765.06,"90th_percentile":10765.06,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":103335.35,"10th_percentile":103335.35,"90th_percentile":103335.35},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11392.94,"10th_percentile":11392.94,"90th_percentile":11392.94,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10852.83,"10th_percentile":10852.83,"90th_percentile":11558.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":55897.86,"10th_percentile":55897.86,"90th_percentile":55897.86,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":34209.36,"10th_percentile":34209.36,"90th_percentile":34209.36,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":33815.3,"10th_percentile":33815.3,"90th_percentile":35162.8,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13113.77,"maximum":29952.87,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13113.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20982.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15736.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29952.87},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13113.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25460.87},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27555.9},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19014.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13113.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26227.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13113.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13113.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13113.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18359.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16392.21,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":14901.28,"10th_percentile":14901.28,"90th_percentile":16676.98,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":15905.6,"10th_percentile":15905.6,"90th_percentile":15905.6,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16884.77,"10th_percentile":16884.77,"90th_percentile":23501.33,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22363.19,"10th_percentile":22363.19,"90th_percentile":22363.19,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":22933.34,"10th_percentile":22933.34,"90th_percentile":22933.34,"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":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":40952.08,"10th_percentile":40952.08,"90th_percentile":40952.08,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42095.94,"10th_percentile":42095.94,"90th_percentile":42095.94,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":37247.37,"10th_percentile":37247.37,"90th_percentile":37247.37,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":46712.21,"10th_percentile":46712.21,"90th_percentile":46712.21,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4853.78,"maximum":10599.77,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4853.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7766.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5824.54,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10599.77},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4853.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9010.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9751.53},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7037.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4853.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9707.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4853.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4853.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4950.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4853.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6795.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6067.22,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8357.1,"10th_percentile":8357.1,"90th_percentile":8357.1,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5665.63,"10th_percentile":5665.63,"90th_percentile":5665.63,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7604.96,"10th_percentile":7604.96,"90th_percentile":7604.96,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11761.42,"maximum":26313.02,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11761.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18818.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14113.7,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26313.02},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11761.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22366.88},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24207.32},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17054.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11761.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23522.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11761.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11761.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11996.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11761.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16465.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14701.78,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4734.58,"maximum":10805.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4734.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7575.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5681.5,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10805.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4734.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9184.98},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9940.76},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6865.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4734.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9469.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4734.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4734.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4829.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4734.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6628.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5918.22,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":5471.15,"10th_percentile":5471.15,"90th_percentile":5471.15},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":246.88,"10th_percentile":246.88,"90th_percentile":246.88,"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5754.25,"10th_percentile":5754.25,"90th_percentile":5754.25,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8098.99,"maximum":18234.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8098.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12958.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9718.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18234.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8098.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15500.0},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16775.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11743.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8098.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16197.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8098.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8098.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8260.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8098.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11338.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10123.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9825.03,"10th_percentile":9825.03,"90th_percentile":9825.03,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5028.47,"maximum":12181.06,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5028.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8045.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6034.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12181.06},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5028.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10354.28},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11206.27},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7291.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5028.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10056.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5028.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5028.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5129.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5028.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7039.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6285.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9121.82,"maximum":22210.35,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14594.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10946.18,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22210.35},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18879.49},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20432.97},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13226.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18243.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9304.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12770.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11402.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5149.05,"maximum":12012.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5149.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8238.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6178.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12012.33},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5149.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10210.85},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11051.04},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5149.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10298.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5149.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5149.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5149.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7208.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6436.31,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":5560.01,"10th_percentile":5560.01,"90th_percentile":5560.01,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14505.85,"maximum":36862.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14505.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23209.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17407.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":36862.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14505.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31334.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":33913.02},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21033.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14505.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14505.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14505.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14795.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14505.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20308.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18132.31,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Procedures Without Cc/Mcc","code_information":[{"code":"145","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8236.7,"maximum":19038.13,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8236.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13178.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9884.04,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19038.13},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8236.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16183.0},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17514.6},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11943.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8236.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16473.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8236.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8236.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8401.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8236.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11531.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10295.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9579.37,"10th_percentile":9579.37,"90th_percentile":9579.37,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11871.72,"maximum":28228.56,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11871.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18994.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14246.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28228.56},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11871.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23995.16},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25969.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17213.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11871.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23743.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11871.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11871.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12109.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11871.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16620.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14839.65,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15608.03,"10th_percentile":15608.03,"90th_percentile":15608.03,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":29335.25,"10th_percentile":29335.25,"90th_percentile":29335.25,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":29406.6,"10th_percentile":29406.6,"90th_percentile":29406.6,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":51408.12,"10th_percentile":51408.12,"90th_percentile":51408.12},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":28497.25,"10th_percentile":28497.25,"90th_percentile":28497.25,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10936.59,"maximum":25266.86,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10936.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17498.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13123.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25266.86},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10936.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21477.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23244.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15858.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10936.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21873.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10936.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10936.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11155.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10936.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15311.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13670.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14942.24,"maximum":34523.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23907.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17930.69,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34523.18},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29345.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31760.47},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21666.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29884.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15241.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20919.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18677.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":29220.64,"maximum":67960.03,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46753.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35064.77,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":67960.03},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":57768.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":62521.54},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":42369.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58441.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29805.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29220.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40908.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36525.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10229.59,"maximum":22473.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10229.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16367.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12275.51,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22473.9},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10229.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19103.51},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20675.42},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14832.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10229.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20459.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10229.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10229.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10434.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10229.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14321.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12786.99,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6955.6,"maximum":15719.67,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11128.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8346.72,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15719.67},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13362.21},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14461.71},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10085.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13911.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7094.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9737.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8694.5,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":7361.55,"10th_percentile":7361.55,"90th_percentile":7361.55,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6831.76,"10th_percentile":6831.76,"90th_percentile":6831.76,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5383.34,"maximum":10900.28,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5383.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8613.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6460.01,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10900.28},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5383.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9265.58},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10027.99},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7805.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5383.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10766.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5383.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5383.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5491.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5383.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7536.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6729.18,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7969.52,"maximum":18691.02,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12751.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9563.42,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18691.02},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15887.95},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17195.27},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11555.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15939.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8128.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11157.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9961.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6873.95,"10th_percentile":6873.95,"90th_percentile":6873.95,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13662.71,"10th_percentile":13662.71,"90th_percentile":13662.71,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7553.91,"10th_percentile":7553.91,"90th_percentile":7553.91,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7679.04,"maximum":18631.56,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7679.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12286.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9214.85,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18631.56},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7679.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15837.4},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17140.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11134.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7679.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15358.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7679.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7679.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7832.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7679.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10750.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9598.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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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":"1 through 10","median_amount":8189.17,"10th_percentile":2323.79,"90th_percentile":8772.96,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8014.64,"10th_percentile":8014.64,"90th_percentile":8014.64,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13268.6,"maximum":31902.16,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13268.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21229.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15922.32,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31902.16},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13268.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27117.83},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29349.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19239.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13268.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26537.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13268.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13268.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13533.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13268.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18576.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16585.75,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11431.19,"10th_percentile":11431.19,"90th_percentile":11431.19,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15571.03,"10th_percentile":15571.03,"90th_percentile":15571.03,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15059.62,"10th_percentile":15059.62,"90th_percentile":15774.13,"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":"Magellan","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":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":25405.64,"10th_percentile":25405.64,"90th_percentile":25405.64,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24743.66,"maximum":57607.74,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24743.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39589.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29692.39,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":57607.74},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24743.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":48968.37},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":52997.68},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35878.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24743.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49487.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24743.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24743.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25238.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24743.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34641.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30929.58,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":25041.26,"10th_percentile":25041.26,"90th_percentile":25041.26,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":30016.98,"10th_percentile":30016.98,"90th_percentile":30016.98,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17669.54,"maximum":38519.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28271.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21203.45,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":38519.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":32743.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":35437.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25620.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35339.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18022.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24737.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22086.92,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44836.15,"10th_percentile":44836.15,"90th_percentile":44836.15,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":29342.67,"10th_percentile":29342.67,"90th_percentile":29342.67,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17669.54,"maximum":38519.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28271.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21203.45,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":38519.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":32743.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":35437.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25620.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35339.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18022.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17669.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24737.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22086.92,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":20187.09,"10th_percentile":20187.09,"90th_percentile":20187.09,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19381.88,"10th_percentile":19381.88,"90th_percentile":19381.88,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24110.64,"maximum":58629.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24110.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38577.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28932.77,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":58629.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24110.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":49837.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":53937.95},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":34960.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24110.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48221.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24110.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24110.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24592.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24110.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33754.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30138.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16414.26,"10th_percentile":16414.26,"90th_percentile":16414.26,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":32418.17,"10th_percentile":32418.17,"90th_percentile":32418.17,"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5455.28,"maximum":12684.05,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5455.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8728.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6546.34,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12684.05},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5455.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10781.84},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11669.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7910.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5455.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10910.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5455.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5455.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5564.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5455.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7637.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6819.1,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7008.35,"maximum":17014.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7008.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11213.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8410.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17014.92},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7008.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14463.21},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15653.3},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10162.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7008.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14016.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7008.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7008.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7148.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7008.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9811.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8760.44,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":28876.68,"10th_percentile":28876.68,"90th_percentile":28876.68,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7993.41,"10th_percentile":7993.41,"90th_percentile":7993.41,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12031.34,"maximum":29292.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12031.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19250.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14437.61,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29292.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12031.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24899.45},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26948.28},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17445.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12031.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24062.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12031.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12031.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12031.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16843.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15039.18,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16196.21,"10th_percentile":16196.21,"90th_percentile":16196.21,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9853.14,"10th_percentile":9853.14,"90th_percentile":9853.14,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6266.41,"maximum":14205.88,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6266.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10026.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7519.69,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14205.88},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6266.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12075.44},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13069.06},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9086.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6266.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12532.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6266.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6266.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6391.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6266.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8772.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7833.01,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7147.33,"10th_percentile":7147.33,"90th_percentile":7147.33,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8924.51,"maximum":21077.41,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8924.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14279.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10709.41,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21077.41},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8924.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17916.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19390.69},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8924.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17849.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8924.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8924.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9103.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8924.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12494.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11155.64,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11681.05,"10th_percentile":11681.05,"90th_percentile":11681.05,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":12756.94,"10th_percentile":12756.94,"90th_percentile":12756.94,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":11782.18,"10th_percentile":11782.18,"90th_percentile":11782.18,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10604.57,"10th_percentile":10604.57,"90th_percentile":10604.57,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15564.29,"maximum":36413.01,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24902.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18677.15,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":36413.01},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":30952.19},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":33499.07},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":22568.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31128.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15875.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21790.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19455.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":11651.41,"10th_percentile":11651.41,"90th_percentile":11651.41,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6547.98,"maximum":15362.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6547.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10476.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7857.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15362.92},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6547.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13058.96},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14133.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9494.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6547.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13095.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6547.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6547.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6678.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6547.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9167.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8184.98,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":5087.04,"10th_percentile":5087.04,"90th_percentile":5087.04,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":27148.3,"10th_percentile":27148.3,"90th_percentile":27148.3},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9562.32,"maximum":22342.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9562.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15299.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11474.78,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22342.12},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9562.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18991.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20554.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13865.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9562.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19124.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9562.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9562.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9753.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9562.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13387.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11952.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":11678.96,"10th_percentile":11678.96,"90th_percentile":12427.06,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":12701.81,"10th_percentile":12701.81,"90th_percentile":12701.81,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15658.15,"maximum":37284.01,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25053.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18789.78,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":37284.01},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31692.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":34300.36},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":22704.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31316.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15971.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15658.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21921.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19572.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20340.71,"10th_percentile":20340.71,"90th_percentile":20340.71,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":18398.21,"10th_percentile":18398.21,"90th_percentile":18633.37,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20614.65,"10th_percentile":20614.65,"90th_percentile":20614.65,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24120.55,"10th_percentile":24120.55,"90th_percentile":24120.55,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6135.56,"maximum":14540.14,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6135.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9816.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7362.67,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14540.14},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6135.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12359.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13376.56},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8896.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6135.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12271.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6135.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6135.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6258.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6135.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8589.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7669.45,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12399.92,"maximum":31943.95,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12399.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19839.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14879.9,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31943.95},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12399.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27153.35},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29387.64},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17979.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12399.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24799.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12399.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12399.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12647.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12399.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17359.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15499.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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","minimum":9107.12,"maximum":10713.87,"payers_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10713.87},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9107.12},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9856.49}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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","minimum":13629.95,"maximum":16034.65,"payers_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16034.65},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13629.95},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14751.48}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8866.2,"10th_percentile":8866.2,"90th_percentile":8866.2,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5234.24,"10th_percentile":5234.24,"90th_percentile":5234.24,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: 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","minimum":21121.09,"maximum":24847.43,"payers_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24847.43},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21121.09},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22859.02}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":8870.87,"10th_percentile":8870.87,"90th_percentile":8870.87,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":11885.3,"10th_percentile":11885.3,"90th_percentile":11885.3,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13136.38,"maximum":27678.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13136.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21018.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15763.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27678.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13136.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23527.98},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25463.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19047.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13136.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26272.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13136.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13136.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13399.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13136.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18390.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16420.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7061.79,"maximum":16751.37,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11298.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8474.15,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16751.37},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14239.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15410.84},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10239.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14123.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7203.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9886.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8827.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8472.64,"10th_percentile":8472.64,"90th_percentile":8472.64,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16751.37,"10th_percentile":16751.37,"90th_percentile":16751.37,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":27556.19,"10th_percentile":27556.19,"90th_percentile":27556.19,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8277.4,"10th_percentile":8277.4,"90th_percentile":8277.4,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10990.71,"maximum":24836.19,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10990.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17585.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13188.85,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24836.19},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10990.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21111.53},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22848.67},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15936.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10990.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21981.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10990.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10990.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10990.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15386.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13738.39,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13732.44,"10th_percentile":13732.44,"90th_percentile":13732.44,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11846.42,"10th_percentile":11846.42,"90th_percentile":11846.42,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16665.97,"10th_percentile":16665.97,"90th_percentile":16665.97,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5180.56,"maximum":12054.11,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5180.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8288.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6216.67,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12054.11},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5180.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10246.37},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11089.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7511.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5180.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10361.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5180.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5180.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5284.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5180.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7252.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6475.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3137.5,"10th_percentile":3137.5,"90th_percentile":3137.5,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9363.75,"10th_percentile":9363.75,"90th_percentile":9363.75,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9628.74,"10th_percentile":9628.74,"90th_percentile":9628.74,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8521.01,"10th_percentile":8521.01,"90th_percentile":8521.01,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8480.94,"10th_percentile":8480.94,"90th_percentile":8480.94,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11405.18,"maximum":27940.91,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11405.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18248.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13686.22,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27940.91},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11405.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23750.64},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25704.94},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16537.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11405.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22810.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11405.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11405.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11633.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11405.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15967.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14256.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5472.4,"maximum":12859.21,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5472.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8755.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6566.88,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12859.21},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5472.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10930.73},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11830.16},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7934.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5472.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10944.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5472.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5472.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5581.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5472.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7661.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6840.5,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":95045.25,"10th_percentile":95045.25,"90th_percentile":95045.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":31.86,"10th_percentile":31.86,"90th_percentile":31.86,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12122.98,"10th_percentile":12122.98,"90th_percentile":12122.98,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20690.05,"maximum":46071.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20690.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33104.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24828.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":46071.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20690.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39161.85},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":42384.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":30000.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20690.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41380.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20690.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20690.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21103.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20690.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28966.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25862.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14499.31,"10th_percentile":14499.31,"90th_percentile":17042.59,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17126.89,"10th_percentile":17126.89,"90th_percentile":17126.89,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21478.65,"10th_percentile":21478.65,"90th_percentile":21478.65,"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."}]}]},{"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":24383.3,"maximum":60166.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24383.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39013.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29259.96,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":60166.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24383.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":51143.04},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":55351.3},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35355.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24383.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48766.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24383.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24383.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24870.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24383.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34136.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30479.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13053.3,"10th_percentile":13053.3,"90th_percentile":13053.3,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":29579.82,"10th_percentile":29579.82,"90th_percentile":29579.82,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7742.0,"10th_percentile":7742.0,"90th_percentile":7742.0,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10333.72,"maximum":23489.52,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10333.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16533.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12400.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23489.52},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10333.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19966.82},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21609.77},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14983.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10333.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10333.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10333.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10540.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10333.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14467.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12917.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12987.88,"10th_percentile":12987.88,"90th_percentile":12987.88,"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":"1 through 10","median_amount":13350.31,"10th_percentile":13350.31,"90th_percentile":13350.31,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":11818.97,"10th_percentile":11818.21,"90th_percentile":12536.02,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11622.73,"10th_percentile":11622.73,"90th_percentile":11622.73,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10963.31,"maximum":25662.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10963.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17541.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13155.97,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25662.18},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10963.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21813.65},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23608.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15896.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10963.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21926.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10963.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10963.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11182.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10963.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15348.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13704.14,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17161.99,"10th_percentile":17161.99,"90th_percentile":17161.99,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16309.57,"10th_percentile":14962.81,"90th_percentile":17336.61,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11016.49,"10th_percentile":11016.49,"90th_percentile":11016.49,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17161.99,"10th_percentile":17161.99,"90th_percentile":17161.99,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20736.22,"10th_percentile":20736.22,"90th_percentile":20736.22,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15617.41,"10th_percentile":15543.7,"90th_percentile":15622.32,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17161.99,"10th_percentile":17161.99,"90th_percentile":17161.99,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5921.82,"maximum":14167.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5921.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9474.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7106.18,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14167.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5921.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12042.66},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13033.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8586.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5921.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11843.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5921.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5921.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6040.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5921.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8290.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7402.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":15940.41,"10th_percentile":15940.41,"90th_percentile":15940.41,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13256.15,"10th_percentile":13256.15,"90th_percentile":13256.15,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4688.68,"maximum":11060.98,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4688.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7501.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5626.42,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11060.98},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4688.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9402.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10175.83},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6798.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4688.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9377.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4688.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4688.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4782.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4688.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6564.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5860.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11246.06,"10th_percentile":11246.06,"90th_percentile":11246.06,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6148.39,"10th_percentile":6148.39,"90th_percentile":6148.39,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6115.44,"10th_percentile":6115.44,"90th_percentile":6115.44,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4202.91,"10th_percentile":3830.51,"90th_percentile":5286.0,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5565.05,"10th_percentile":5565.05,"90th_percentile":5565.05,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6299.14,"10th_percentile":6299.14,"90th_percentile":6299.14,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6921.35,"maximum":16343.19,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11074.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8305.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16343.19},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13892.22},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15035.33},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10035.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13842.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7059.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9689.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8651.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":8131.51,"10th_percentile":6751.28,"90th_percentile":8878.76,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10353.28,"10th_percentile":10353.28,"90th_percentile":10353.28,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9035.0,"10th_percentile":9035.0,"90th_percentile":9035.0,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6078.83,"10th_percentile":6078.83,"90th_percentile":6078.83,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":56105.48,"10th_percentile":56105.48,"90th_percentile":56105.48},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13776.92,"maximum":31964.84,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13776.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22043.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16532.3,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31964.84},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13776.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27171.11},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29406.85},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19976.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13776.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27553.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13776.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13776.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14052.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13776.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19287.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17221.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17673.75,"10th_percentile":17673.75,"90th_percentile":18365.97,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":16324.37,"10th_percentile":15441.47,"90th_percentile":18498.33,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":23799.36,"10th_percentile":23799.36,"90th_percentile":23799.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17673.75,"10th_percentile":9035.0,"90th_percentile":17673.75,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18889.83,"10th_percentile":16187.48,"90th_percentile":21050.77,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16082.38,"10th_percentile":7148.05,"90th_percentile":16713.03,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17805.97,"10th_percentile":17805.97,"90th_percentile":44895.11,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9617.13,"maximum":22573.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15387.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11540.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22573.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19188.2},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20767.08},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13944.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19234.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13463.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12021.41,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37720.38,"10th_percentile":37720.38,"90th_percentile":37720.38,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18888.29,"maximum":43440.42,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18888.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30221.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22665.95,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":43440.42},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18888.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":36925.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":39964.11},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27388.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18888.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37776.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18888.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18888.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19266.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18888.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26443.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23610.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6301.35,"maximum":14340.87,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6301.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10082.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7561.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14340.87},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6301.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12190.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13193.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9136.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6301.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12602.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6301.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6301.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6427.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6301.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8821.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7876.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12499.48,"10th_percentile":12499.48,"90th_percentile":12499.48,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8501.14,"maximum":19661.65,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8501.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13601.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10201.37,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19661.65},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8501.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16713.01},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18088.22},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12326.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8501.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17002.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8501.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8501.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8671.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8501.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11901.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10626.42,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11711.41,"maximum":29660.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11711.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18738.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14053.69,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29660.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11711.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25212.26},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27286.83},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16981.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11711.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23422.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11711.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11711.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11945.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11711.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16395.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14639.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18563.58,"10th_percentile":18563.58,"90th_percentile":18563.58,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":22702.34,"10th_percentile":11970.77,"90th_percentile":44554.84,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6187.86,"10th_percentile":6187.86,"90th_percentile":6187.86,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23284.55,"10th_percentile":14645.39,"90th_percentile":44554.84,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18749.22,"10th_percentile":14837.97,"90th_percentile":43748.17,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23280.55,"10th_percentile":23280.55,"90th_percentile":27923.5,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15915.05,"maximum":40239.28,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25464.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19098.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":40239.28},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":34204.64},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":37019.14},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":23076.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31830.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16233.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22281.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19893.81,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29729.05,"10th_percentile":29729.05,"90th_percentile":29729.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2062.62,"10th_percentile":2062.62,"90th_percentile":2062.62,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":9050.4,"10th_percentile":9050.4,"90th_percentile":9050.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":31811.53,"10th_percentile":31811.53,"90th_percentile":31811.53,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18749.22,"10th_percentile":18749.22,"90th_percentile":42394.14,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":40622.48,"10th_percentile":40622.48,"90th_percentile":40622.48,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6985.06,"maximum":17530.76,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6985.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11176.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8382.07,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17530.76},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6985.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14901.69},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16127.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10128.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6985.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13970.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6985.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6985.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7124.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6985.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9779.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8731.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9398.74,"10th_percentile":9398.74,"90th_percentile":9398.74,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10460.46,"maximum":24090.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10460.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16736.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12552.55,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24090.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10460.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20477.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22162.69},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15167.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10460.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20920.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10460.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10460.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10669.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10460.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14644.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13075.58,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":14710.07,"10th_percentile":14710.07,"90th_percentile":14710.07,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13319.29,"10th_percentile":13319.29,"90th_percentile":13319.29,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12120.55,"10th_percentile":12120.55,"90th_percentile":12120.55,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6708.29,"maximum":14805.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6708.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10733.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8049.95,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14805.29},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6708.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12584.96},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13620.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9727.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6708.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13416.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6708.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6708.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6842.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6708.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9391.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8385.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12408.82,"maximum":32339.27,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12408.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19854.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14890.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":32339.27},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12408.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27489.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29751.32},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17992.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12408.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24817.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12408.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12408.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12657.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12408.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17372.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15511.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13573.37,"10th_percentile":13573.37,"90th_percentile":13573.37,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20063.78,"10th_percentile":20063.78,"90th_percentile":20063.78,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21915.16,"10th_percentile":21915.16,"90th_percentile":21915.16,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18272.97,"10th_percentile":18272.97,"90th_percentile":18272.97,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19978.04,"10th_percentile":19978.04,"90th_percentile":20240.54,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":26452.24,"maximum":60612.83,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26452.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42323.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31742.69,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":60612.83},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26452.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":51522.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":55762.29},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":38355.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26452.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52904.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26452.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26452.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26981.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26452.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37033.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33065.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9584.13,"10th_percentile":9584.13,"90th_percentile":9584.13,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11116.08,"maximum":25890.38,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17785.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13339.3,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25890.38},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22007.63},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23818.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16118.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22232.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11338.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15562.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13895.1,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13309.7,"maximum":29456.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13309.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15971.64,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29456.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13309.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25038.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27099.07},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19299.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13309.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26619.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13309.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13309.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13575.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13309.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18633.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16637.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28775.76,"10th_percentile":25655.19,"90th_percentile":41771.78,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16100.04,"10th_percentile":16100.04,"90th_percentile":16100.04,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16286.83,"10th_percentile":16286.83,"90th_percentile":16286.83,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17624.2,"10th_percentile":17624.2,"90th_percentile":17624.2,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16286.83,"10th_percentile":16286.83,"90th_percentile":16286.83,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10469.97,"10th_percentile":10469.97,"90th_percentile":10469.97,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":46466.19,"10th_percentile":46466.19,"90th_percentile":46466.19},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":16705.56,"10th_percentile":16359.06,"90th_percentile":18459.4,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":26517.32,"maximum":62488.2,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26517.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42427.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31820.78,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":62488.2},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26517.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":53116.91},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":57487.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":38450.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26517.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53034.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26517.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26517.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27047.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26517.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37124.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33146.65,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32806.07,"10th_percentile":32806.07,"90th_percentile":32806.07,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11392.17,"maximum":25638.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11392.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18227.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13670.6,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25638.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11392.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21793.16},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23586.39},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16518.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11392.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22784.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11392.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11392.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11620.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11392.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15949.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14240.21,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14599.02,"maximum":34317.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14599.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23358.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17518.82,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34317.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14599.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29170.93},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31571.23},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21168.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14599.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29198.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14599.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14599.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14891.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14599.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20438.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18248.78,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":30694.93,"maximum":67338.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30694.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49111.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36833.92,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":67338.12},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30694.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":57239.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":61949.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":44507.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30694.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61389.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30694.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30694.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31308.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30694.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42972.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38368.66,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15038.84,"maximum":35758.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24062.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18046.61,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":35758.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":30396.23},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":32897.36},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21806.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30077.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15339.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21054.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18798.55,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18243.89,"10th_percentile":18243.89,"90th_percentile":18243.89,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":23372.13,"maximum":53938.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23372.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37395.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28046.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":53938.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23372.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":45849.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":49622.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":33889.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23372.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46744.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23372.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23372.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23839.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23372.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32720.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29215.16,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":41161.56,"maximum":97691.14,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41161.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65858.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49393.87,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":97691.14},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41161.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":83040.51},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":89873.41},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":59684.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41161.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82323.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41161.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41161.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41984.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41161.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57626.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51451.95,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":52486.05,"10th_percentile":52486.05,"90th_percentile":52486.05,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17283.84,"maximum":39654.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17283.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27654.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20740.61,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":39654.33},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17283.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":33707.42},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":36481.0},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25061.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17283.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34567.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17283.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17283.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17629.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17283.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24197.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21604.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":31148.45,"maximum":71865.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49837.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37378.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":71865.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":61087.52},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":66114.05},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":45165.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62296.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31771.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43607.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38935.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":31767.08,"maximum":77921.82,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31767.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50827.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38120.5,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":77921.82},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31767.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":66235.97},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":71686.14},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":46062.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31767.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63534.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31767.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31767.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32402.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31767.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44473.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39708.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":70634.99,"maximum":171123.0,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70634.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":113015.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":84761.99,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":171123.0},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70634.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":145459.88},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":157428.9},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":102420.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70634.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":141269.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70634.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70634.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":72047.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70634.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98888.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88293.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":65945.77,"10th_percentile":65945.77,"90th_percentile":65945.77,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":151636.4,"10th_percentile":151636.4,"90th_percentile":151636.4,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":89021.41,"10th_percentile":89021.41,"90th_percentile":111991.6,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":126346.83,"10th_percentile":126346.83,"90th_percentile":126346.83,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":145409.23,"maximum":344383.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":145409.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":232654.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":174491.08,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":344383.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":145409.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":292736.53},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":316824.08},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":210843.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":145409.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":290818.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":145409.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":145409.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":148317.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":145409.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":203572.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":181761.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":189486.35,"10th_percentile":189085.28,"90th_percentile":241852.55,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":191985.64,"maximum":452634.05,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191985.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":307177.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":230382.77,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":452634.05},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191985.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":384753.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":416412.06},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":278379.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191985.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":383971.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191985.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191985.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":195825.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191985.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":268779.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":239982.05,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":304026.18,"10th_percentile":304026.18,"90th_percentile":304026.18,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":184158.83,"10th_percentile":184158.83,"90th_percentile":184158.83,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15726.66,"maximum":38031.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15726.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25162.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18871.99,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":38031.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15726.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":32327.76},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":34987.81},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":22803.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15726.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31453.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15726.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15726.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15726.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22017.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19658.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8126.4,"maximum":20010.36,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13002.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9751.68,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20010.36},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17009.43},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18409.04},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11783.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16252.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8288.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11376.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10158.0,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6275.32,"maximum":14843.86,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6275.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10040.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7530.38,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14843.86},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6275.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12617.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13655.98},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9099.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6275.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12550.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6275.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6275.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6400.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6275.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8785.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7844.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8327.01,"10th_percentile":8327.01,"90th_percentile":8327.01,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":9739.82,"10th_percentile":9739.82,"90th_percentile":9739.82},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":8467.27,"10th_percentile":8467.27,"90th_percentile":8467.27,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7468.32,"10th_percentile":7468.32,"90th_percentile":7468.32,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10085.04,"maximum":23875.2,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10085.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16136.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12102.05,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23875.2},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10085.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20294.66},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21964.59},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14623.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10085.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20170.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10085.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10085.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10286.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10085.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14119.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12606.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":16296.86,"10th_percentile":16296.86,"90th_percentile":16296.86,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12234.33,"10th_percentile":12234.33,"90th_percentile":12234.33,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5966.35,"maximum":14156.06,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5966.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9546.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7159.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14156.06},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5966.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12033.09},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13023.23},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8651.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5966.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11932.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5966.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5966.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6085.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5966.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8352.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7457.94,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":62435.62,"10th_percentile":62435.62,"90th_percentile":62435.62},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7043.2,"10th_percentile":7043.2,"90th_percentile":7043.2,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7272.03,"10th_percentile":7272.03,"90th_percentile":8614.32,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14154.46,"10th_percentile":14154.46,"90th_percentile":14154.46,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7825.78,"10th_percentile":7825.78,"90th_percentile":7825.78,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7825.78,"10th_percentile":7825.78,"90th_percentile":7825.78,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7886.52,"10th_percentile":6143.13,"90th_percentile":8109.08,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7953.72,"10th_percentile":7953.72,"90th_percentile":7953.72,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3613.36,"10th_percentile":3613.36,"90th_percentile":3613.36,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7825.78,"10th_percentile":7825.78,"90th_percentile":13591.45,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8025.29,"10th_percentile":8025.29,"90th_percentile":8271.26,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7121.46,"10th_percentile":7121.46,"90th_percentile":7237.89,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5809.93,"10th_percentile":5809.93,"90th_percentile":5809.93,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9737.02,"maximum":23613.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15579.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11684.42,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23613.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20072.0},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21723.61},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14118.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19474.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9931.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13631.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12171.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13154.96,"10th_percentile":13154.96,"90th_percentile":13156.96,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13479.17,"10th_percentile":13479.17,"90th_percentile":13479.17,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11812.16,"10th_percentile":11812.16,"90th_percentile":11878.8,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4144.72,"maximum":9633.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4144.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6631.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4973.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":9633.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4144.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8189.17},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":8863.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6009.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4144.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8289.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4144.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4144.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4227.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4144.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5802.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5180.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16957.66,"10th_percentile":16957.66,"90th_percentile":16957.66,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignant Breast Disorders With Mcc","code_information":[{"code":"597","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11420.94,"maximum":28226.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11420.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18273.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13705.13,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28226.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11420.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23993.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25968.1},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16560.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11420.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22841.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11420.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11420.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11649.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11420.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15989.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14276.18,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":14881.73,"10th_percentile":14881.73,"90th_percentile":14881.73,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7415.97,"maximum":17371.67,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7415.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11865.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8899.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17371.67},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7415.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14766.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15981.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10753.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7415.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14831.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7415.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7415.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7564.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7415.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10382.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9269.96,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14528.45,"maximum":33988.05,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14528.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17434.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":33988.05},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14528.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28890.9},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31268.16},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21066.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14528.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29056.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14528.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14528.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14819.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14528.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20339.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18160.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8127.08,"maximum":19647.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8127.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13003.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9752.5,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19647.18},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8127.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16700.72},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18074.92},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11784.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8127.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16254.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8127.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8127.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8289.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8127.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11377.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10158.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9859.1,"10th_percentile":9859.1,"90th_percentile":9859.1,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13258.32,"maximum":33043.13,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21213.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15909.98,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":33043.13},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28087.69},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":30398.86},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19224.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26516.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13523.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18561.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16572.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":18376.9,"10th_percentile":18376.9,"90th_percentile":18376.9,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13215.84,"maximum":31898.95,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13215.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21145.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15859.01,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31898.95},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13215.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27115.1},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29346.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19162.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13215.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26431.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13215.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13215.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13480.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13215.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18502.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16519.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13198.72,"maximum":28140.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21117.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15838.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28140.18},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23920.03},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25888.26},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19138.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26397.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13462.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13198.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18478.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16498.4,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14112.91,"10th_percentile":14112.91,"90th_percentile":14112.91,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":22186.26,"maximum":52373.74,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35498.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26623.51,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":52373.74},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":44519.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":48182.53},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":32170.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44372.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22629.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27732.82,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":44927.79,"10th_percentile":44927.79,"90th_percentile":44927.79,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":38318.24,"10th_percentile":38318.24,"90th_percentile":38318.24},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":28115.12,"10th_percentile":28115.12,"90th_percentile":28115.12,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11005.1,"maximum":27163.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11005.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17608.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13206.12,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27163.12},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11005.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23089.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24989.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15957.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11005.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22010.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11005.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11005.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11225.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11005.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15407.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13756.38,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18159.37,"maximum":42787.98,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18159.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29054.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21791.24,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":42787.98},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18159.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":36371.12},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":39363.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":26331.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18159.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36318.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18159.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18159.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18522.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18159.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25423.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22699.21,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":23781.81,"maximum":55677.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38050.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28538.17,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":55677.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":47327.8},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":51222.12},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":34483.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47563.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24257.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33294.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29727.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":30785.13,"10th_percentile":30785.13,"90th_percentile":30785.13,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":644.13,"10th_percentile":644.13,"90th_percentile":644.13,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6585.66,"maximum":15488.27,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10537.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7902.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15488.27},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13165.51},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14248.82},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9549.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13171.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6717.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9219.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8232.08,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":8589.21,"10th_percentile":8589.21,"90th_percentile":10433.37,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14915.04,"10th_percentile":14915.04,"90th_percentile":14915.04,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7532.2,"10th_percentile":7532.2,"90th_percentile":7532.2,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":6797.36,"10th_percentile":6797.36,"90th_percentile":8214.53,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8563.22,"10th_percentile":8563.22,"90th_percentile":8563.22,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8786.09,"10th_percentile":8563.22,"90th_percentile":10446.06,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7792.53,"10th_percentile":7792.53,"90th_percentile":7792.53,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7845.91,"10th_percentile":7845.91,"90th_percentile":7845.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8270.26,"maximum":19364.35,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8270.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13232.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9924.31,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19364.35},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8270.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16460.3},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17814.72},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11991.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8270.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16540.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8270.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8270.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8435.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8270.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11578.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10337.82,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13228.18,"maximum":32373.02,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21165.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15873.82,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":32373.02},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27518.07},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29782.37},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19180.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26456.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13492.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18519.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16535.22,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17335.59,"10th_percentile":17335.59,"90th_percentile":17335.59,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5728.62,"maximum":11991.43,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9165.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6874.34,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11991.43},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10193.09},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11031.82},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8306.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11457.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5843.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8020.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7160.78,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7901.69,"maximum":18604.24,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7901.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12642.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9482.03,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18604.24},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7901.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15814.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17115.44},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11457.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7901.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15803.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7901.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7901.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8059.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7901.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11062.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9877.11,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9360.3,"10th_percentile":9360.3,"90th_percentile":9360.3,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17001.59,"maximum":40604.07,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17001.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27202.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20401.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":40604.07},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17001.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":34514.72},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":37354.73},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":24652.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17001.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34003.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17001.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17001.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17341.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17001.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23802.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21251.99,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17649.45,"10th_percentile":17649.45,"90th_percentile":17649.45,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5169.6,"maximum":12144.1,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5169.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8271.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6203.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12144.1},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5169.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10322.86},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11172.27},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7495.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5169.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10339.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5169.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5169.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5272.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5169.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7237.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6462.0,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22928.6,"10th_percentile":22928.6,"90th_percentile":22928.6,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5394.31,"maximum":14058.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5394.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8630.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6473.17,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14058.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5394.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11949.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12933.04},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7821.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5394.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10788.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5394.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5394.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5502.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5394.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7552.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6742.89,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7773.36,"10th_percentile":7773.36,"90th_percentile":7773.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8880.67,"maximum":20801.01,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8880.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14209.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10656.8,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20801.01},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8880.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17681.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19136.41},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12876.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8880.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17761.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8880.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8880.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9058.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8880.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12432.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11100.84,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10925.31,"10th_percentile":10925.31,"90th_percentile":10925.31,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":10103.35,"10th_percentile":10103.35,"90th_percentile":10103.35,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10773.3,"10th_percentile":10773.3,"90th_percentile":10773.3,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13493.99,"maximum":32504.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21590.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16192.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":32504.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27630.08},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29903.6},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19566.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26987.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13763.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18891.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16867.49,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11605.67,"10th_percentile":11605.67,"90th_percentile":11605.67,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16270.73,"10th_percentile":16270.73,"90th_percentile":16270.73,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4934.62,"maximum":10791.01,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4934.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7895.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5921.54,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10791.01},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4934.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9172.69},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9927.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7155.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4934.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9869.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4934.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4934.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5033.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4934.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6908.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6168.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7309.67,"10th_percentile":7309.67,"90th_percentile":7309.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":10430.29,"10th_percentile":10430.29,"90th_percentile":10430.29,"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":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17503.56,"10th_percentile":16944.96,"90th_percentile":18730.16,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":19663.12,"maximum":46837.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31460.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23595.74,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":46837.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39813.44},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":43089.45},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":28511.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39326.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20056.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27528.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24578.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23868.22,"10th_percentile":23868.22,"90th_percentile":23868.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11587.73,"10th_percentile":11587.73,"90th_percentile":11587.73,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13702.93,"maximum":31685.22,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21924.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16443.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31685.22},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26933.42},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29149.61},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19869.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27405.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13976.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19184.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17128.66,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18267.33,"10th_percentile":18267.33,"90th_percentile":18267.33,"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":25603.43,"maximum":57591.67,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25603.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40965.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30724.12,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":57591.67},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25603.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":48954.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":52982.9},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":37124.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25603.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51206.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25603.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25603.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26115.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25603.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35844.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32004.29,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10527.6,"maximum":23986.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10527.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16844.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12633.12,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23986.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10527.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20388.92},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22066.6},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15265.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10527.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21055.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10527.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10527.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10738.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10527.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14738.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13159.5,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25251.05,"10th_percentile":25251.05,"90th_percentile":25251.05,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14236.61,"maximum":32326.41,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14236.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22778.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17083.93,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":32326.41},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14236.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27478.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29739.49},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20643.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14236.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28473.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14236.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14236.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14521.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14236.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19931.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17795.76,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16086.3,"10th_percentile":16086.3,"90th_percentile":16086.3,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16265.04,"10th_percentile":16265.04,"90th_percentile":16265.04,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":21832.76,"maximum":49691.65,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21832.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34932.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26199.31,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":49691.65},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21832.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":42239.45},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":45715.08},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":31657.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21832.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43665.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21832.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21832.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22269.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21832.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30565.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27290.95,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7003.55,"maximum":16384.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11205.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8404.26,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16384.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13927.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15073.77},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10155.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14007.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7143.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9804.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8754.44,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16798.43,"10th_percentile":16798.43,"90th_percentile":16798.43,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10785.19,"maximum":24193.39,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17256.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12942.23,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24193.39},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20565.13},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22257.31},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15638.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21570.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11000.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15099.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13481.49,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13377.05,"10th_percentile":13377.05,"90th_percentile":13377.05,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12172.35,"10th_percentile":12172.35,"90th_percentile":12172.35,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11340.79,"maximum":25835.74,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18145.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13608.95,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25835.74},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21961.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23768.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16444.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22681.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11567.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15877.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14175.99,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12999.41,"10th_percentile":12999.41,"90th_percentile":12999.41,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14245.52,"maximum":31519.7,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22792.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17094.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31519.7},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26792.72},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28997.34},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20656.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28491.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14530.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19943.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17806.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17561.14,"10th_percentile":17561.14,"90th_percentile":17561.14,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":20236.18,"10th_percentile":20236.18,"90th_percentile":20236.18,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15858.42,"10th_percentile":15858.42,"90th_percentile":15858.42,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20692.79,"maximum":45928.06,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20692.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33108.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24831.35,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":45928.06},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20692.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39040.28},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":42252.67},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":30004.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20692.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41385.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20692.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20692.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21106.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20692.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28969.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25865.99,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16361.43,"10th_percentile":16361.43,"90th_percentile":16361.43,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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","minimum":23993.79,"maximum":28226.96,"payers_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28226.96},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23993.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25968.1}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9243.08,"maximum":24088.93,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9243.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11091.7,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24088.93},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9243.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20476.34},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22161.22},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13402.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9243.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18486.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9243.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9243.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9427.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9243.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12940.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11553.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12805.48,"maximum":28212.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20488.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15366.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28212.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23981.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25954.79},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18567.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25610.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13061.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17927.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16006.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":19121.22,"maximum":42529.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19121.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30593.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22945.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":42529.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19121.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":36151.19},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":39125.86},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27725.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19121.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38242.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19121.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19121.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19503.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19121.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26769.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23901.52,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21964.91,"10th_percentile":21964.91,"90th_percentile":21964.91,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21397.62,"10th_percentile":21397.62,"90th_percentile":21397.62,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9220.47,"maximum":22451.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9220.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14752.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11064.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22451.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9220.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19084.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20654.73},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13369.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9220.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18440.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9220.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9220.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9404.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9220.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12908.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11525.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11975.85,"maximum":28683.34,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19161.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14371.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28683.34},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24381.73},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26387.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17364.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23951.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12215.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16766.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14969.81,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16640.43,"10th_percentile":16640.43,"90th_percentile":16640.43,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":29996.03,"10th_percentile":29996.03,"90th_percentile":29996.03},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15856.8,"10th_percentile":15856.8,"90th_percentile":15856.8,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":21681.36,"maximum":50917.8,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21681.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34690.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26017.63,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":50917.8},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21681.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":43281.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":46843.1},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":31437.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21681.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43362.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21681.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21681.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22114.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21681.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30353.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27101.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13802.96,"maximum":27605.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22084.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16563.55,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18654.06},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15856.53},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17161.27},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20014.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27605.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14079.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19324.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17253.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8277.8,"maximum":21582.01,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8277.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13244.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9933.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21582.01},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8277.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18345.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19854.91},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12002.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8277.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16555.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8277.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8277.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8443.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8277.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11588.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10347.25,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12358.13,"maximum":31704.5,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19773.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14829.76,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31704.5},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26949.81},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29167.35},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17919.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24716.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12605.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17301.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15447.66,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16751.5,"10th_percentile":16751.5,"90th_percentile":16751.5,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15064.3,"10th_percentile":15064.3,"90th_percentile":15064.3,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":18324.87,"10th_percentile":18324.87,"90th_percentile":18324.87},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":19890.32,"10th_percentile":19890.32,"90th_percentile":19890.32,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16220.56,"10th_percentile":16220.56,"90th_percentile":17996.81,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17374.27,"maximum":38584.07,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27798.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20849.12,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":38584.07},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":32797.66},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":35496.38},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25192.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34748.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17721.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24323.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21717.84,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21332.63,"10th_percentile":21332.63,"90th_percentile":21332.63,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29474.24,"10th_percentile":29474.24,"90th_percentile":29595.39,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10729.7,"maximum":25392.21,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17167.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12875.64,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25392.21},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21584.17},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23360.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15558.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21459.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10944.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15021.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13412.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14039.85,"10th_percentile":14039.85,"90th_percentile":14039.85,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14325.67,"maximum":34079.65,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22921.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17190.8,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34079.65},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28968.76},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31352.43},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20772.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28651.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14612.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20055.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17907.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17629.79,"10th_percentile":17629.79,"90th_percentile":17629.79,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":22108.16,"maximum":51803.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22108.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35373.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26529.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":51803.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22108.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":44034.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":47657.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":32056.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22108.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44216.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22108.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22108.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22550.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22108.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30951.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27635.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":28603.02,"10th_percentile":28603.02,"90th_percentile":28603.02,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18989.68,"maximum":40947.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18989.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30383.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22787.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":40947.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18989.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":34807.05},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":37671.11},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27535.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18989.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37979.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18989.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18989.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19369.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18989.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26585.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23737.1,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11173.63,"maximum":25493.45,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17877.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13408.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25493.45},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21670.22},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23453.34},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16201.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22347.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11397.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15643.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13967.04,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26210.17,"10th_percentile":26210.17,"90th_percentile":26210.17,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14094.94,"10th_percentile":14094.94,"90th_percentile":14094.94,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13569.48,"10th_percentile":12759.67,"90th_percentile":14179.31,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":98386.5,"10th_percentile":98386.5,"90th_percentile":98386.5},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15124.78,"10th_percentile":15124.78,"90th_percentile":15124.78,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14895.53,"10th_percentile":14895.53,"90th_percentile":14895.53,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14348.96,"maximum":33343.64,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14348.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22958.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17218.75,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":33343.64},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14348.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28343.13},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":30675.32},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20805.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14348.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28697.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14348.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14348.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14635.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14348.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20088.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17936.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":32333.22,"10th_percentile":32333.22,"90th_percentile":32333.22,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8085.29,"maximum":18689.41,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8085.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12936.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9702.35,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18689.41},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8085.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15886.58},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17193.79},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8085.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16170.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8085.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8085.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8085.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11319.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10106.61,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15590.33,"maximum":34664.6,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15590.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24944.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18708.4,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34664.6},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15590.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29465.99},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31890.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":22605.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15590.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31180.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15590.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15590.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15902.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15590.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21826.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19487.91,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17250.57,"10th_percentile":17250.57,"90th_percentile":17250.57,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10415.87,"10th_percentile":10415.87,"90th_percentile":10415.87,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19267.56,"10th_percentile":19267.56,"90th_percentile":19267.56,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":19318.05,"10th_percentile":19318.05,"90th_percentile":19318.05,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":22486.59,"10th_percentile":22486.59,"90th_percentile":22486.59},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":19695.35,"10th_percentile":19695.35,"90th_percentile":19695.35,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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","code_information":[{"code":"474","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29409.72,"maximum":72064.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29409.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47055.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35291.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":72064.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29409.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":61256.9},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":66297.37},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":42644.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29409.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58819.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29409.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29409.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29997.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29409.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41173.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36762.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":45550.77,"10th_percentile":45550.77,"90th_percentile":45550.77,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":37991.69,"10th_percentile":37991.69,"90th_percentile":37991.69,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":24884.16,"10th_percentile":24884.16,"90th_percentile":24884.16,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","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":16724.82,"maximum":38040.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16724.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26759.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20069.78,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":38040.9},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16724.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":32335.95},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":34996.68},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":24250.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16724.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33449.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16724.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16724.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17059.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16724.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23414.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20906.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":19140.95,"10th_percentile":19140.95,"90th_percentile":19140.95},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":21042.04,"10th_percentile":21042.04,"90th_percentile":21042.04,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20183.09,"maximum":46554.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20183.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32292.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24219.71,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":46554.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20183.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39573.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":42829.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":29265.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20183.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40366.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20183.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20183.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20586.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20183.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28256.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25228.86,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":57886.77,"10th_percentile":57886.77,"90th_percentile":57886.77},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":19786.99,"10th_percentile":19786.99,"90th_percentile":19786.99,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":24226.03,"10th_percentile":24226.03,"90th_percentile":24226.03,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":25741.21,"10th_percentile":25741.21,"90th_percentile":25741.21,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":33080.37,"maximum":78051.99,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33080.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52928.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39696.44,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":78051.99},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33080.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":66346.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":71805.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":47966.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33080.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66160.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33080.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33080.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33741.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33080.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46312.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41350.46,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13214.47,"maximum":30299.99,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13214.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21143.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15857.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30299.99},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13214.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25755.93},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27875.23},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19160.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13214.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26428.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13214.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13214.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13478.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13214.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18500.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16518.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16803.24,"10th_percentile":16803.24,"90th_percentile":16803.24,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16752.46,"10th_percentile":16752.46,"90th_percentile":16752.46,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31695.68,"10th_percentile":31695.68,"90th_percentile":31695.68,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16852.04,"10th_percentile":16842.65,"90th_percentile":16989.7,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16752.4,"10th_percentile":16752.4,"90th_percentile":16752.4,"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":"1 through 10","median_amount":18557.11,"10th_percentile":18557.11,"90th_percentile":18557.11,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15244.68,"10th_percentile":15244.68,"90th_percentile":16030.72,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15853.44,"10th_percentile":15853.44,"90th_percentile":15853.44,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20779.79,"maximum":52524.8,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20779.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33247.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24935.75,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":52524.8},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20779.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":44647.71},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":48321.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":30130.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20779.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41559.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20779.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20779.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21195.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20779.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29091.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25974.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18825.95,"maximum":42154.82,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30121.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22591.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":42154.82},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":35832.91},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":38781.39},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27297.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37651.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19202.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26356.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23532.44,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":58879.93,"10th_percentile":58879.93,"90th_percentile":58879.93,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":52494.18,"10th_percentile":52494.18,"90th_percentile":52494.18},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23522.1,"10th_percentile":23522.1,"90th_percentile":23522.1,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33479.8,"10th_percentile":33479.8,"90th_percentile":33479.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Revision Of Hip Or Knee Replacement With Mcc","code_information":[{"code":"466","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35661.06,"maximum":81865.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35661.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57057.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42793.27,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":81865.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35661.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":69588.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":75314.13},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":51708.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35661.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71322.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35661.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35661.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36374.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35661.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49925.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44576.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":35585.07,"10th_percentile":35585.07,"90th_percentile":35585.07,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit","code_information":[{"code":"465","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12493.77,"maximum":27895.91,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19990.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14992.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27895.91},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23712.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25663.55},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18115.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24987.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12743.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17491.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15617.21,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":15546.75,"10th_percentile":15546.75,"90th_percentile":15546.75,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":28102.71,"10th_percentile":28102.71,"90th_percentile":28102.71,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":48405.6,"10th_percentile":48405.6,"90th_percentile":48405.6,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18223.08,"maximum":46018.05,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18223.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29156.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21867.7,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":46018.05},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18223.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39116.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":42335.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":26423.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18223.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18223.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18223.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18587.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18223.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25512.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22778.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":37836.87,"maximum":98616.77,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37836.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60538.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45404.24,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":98616.77},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37836.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":83827.32},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":90724.97},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":54863.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37836.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75673.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37836.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37836.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38593.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37836.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52971.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47296.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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 Or Custom-Made Anatomically Designed Interbody","code_information":[{"code":"447","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":45774.19,"maximum":107736.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45774.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73238.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54929.03,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":107736.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45774.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":91579.37},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":99114.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":66372.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45774.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91548.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45774.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45774.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46689.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45774.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64083.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57217.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5667.65,"maximum":12811.0,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5667.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9068.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6801.18,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12811.0},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5667.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10889.75},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11785.8},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8218.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5667.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11335.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5667.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5667.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5781.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5667.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7934.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7084.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12812.61,"10th_percentile":12812.61,"90th_percentile":12812.61,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4933.88,"10th_percentile":4933.88,"90th_percentile":4933.88,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":7074.38,"10th_percentile":7074.38,"90th_percentile":7074.38,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":6446.34,"10th_percentile":6446.34,"90th_percentile":6446.34,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7497.5,"maximum":17426.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7497.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11996.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8997.0,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17426.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7497.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14812.9},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16031.77},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10871.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7497.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14995.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7497.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7497.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7647.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7497.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10496.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9371.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":23011.49,"10th_percentile":23011.49,"90th_percentile":23011.49},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8197.94,"10th_percentile":8197.94,"90th_percentile":8328.64,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":9658.51,"10th_percentile":9658.51,"90th_percentile":12115.53,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9508.1,"10th_percentile":9508.1,"90th_percentile":9508.1,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11446.97,"maximum":27069.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18315.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13736.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27069.92},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23010.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24903.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16598.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22893.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11675.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16025.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14308.71,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9216.22,"10th_percentile":9216.22,"90th_percentile":9216.22,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15347.22,"10th_percentile":15347.22,"90th_percentile":15347.22,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13023.83,"10th_percentile":13023.83,"90th_percentile":13023.83,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4793.49,"maximum":11290.78,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4793.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7669.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5752.19,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11290.78},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4793.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9597.52},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10387.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6950.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4793.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9586.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4793.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4793.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4889.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4793.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5991.86,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8516.24,"10th_percentile":7498.45,"90th_percentile":8898.2,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12295.1,"maximum":30377.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12295.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19672.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14754.12,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30377.12},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12295.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25821.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27946.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17827.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12295.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24590.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12295.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12295.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12541.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12295.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17213.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15368.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13073.94,"10th_percentile":13073.94,"90th_percentile":13073.94,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":224231.03,"10th_percentile":224231.03,"90th_percentile":224231.03,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16795.93,"10th_percentile":16795.93,"90th_percentile":16795.93,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16886.43,"10th_percentile":16886.43,"90th_percentile":16886.43,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16795.93,"10th_percentile":16795.93,"90th_percentile":16795.93,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":24866.38,"10th_percentile":24866.38,"90th_percentile":24866.38,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17044.95,"10th_percentile":17044.95,"90th_percentile":17044.95,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15284.3,"10th_percentile":15284.3,"90th_percentile":16938.69,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16886.43,"10th_percentile":16886.43,"90th_percentile":16886.43,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4257.08,"maximum":9884.66,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6811.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5108.5,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":9884.66},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8402.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9093.64},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6172.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8514.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4342.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5959.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5321.35,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":10280.47,"10th_percentile":10280.47,"90th_percentile":10280.47},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4715.43,"10th_percentile":4715.43,"90th_percentile":4715.43,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3646.12,"10th_percentile":3646.12,"90th_percentile":3646.12,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":4906.54,"10th_percentile":4906.54,"90th_percentile":4906.54},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":6744.31,"10th_percentile":6744.31,"90th_percentile":6744.31,"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":"VA Premier","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3645.97,"10th_percentile":3645.97,"90th_percentile":3645.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7538.39,"10th_percentile":7538.39,"90th_percentile":7538.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":7478.6,"10th_percentile":7478.6,"90th_percentile":7478.6,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10019.46,"10th_percentile":10019.46,"90th_percentile":10019.46,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12582.83,"maximum":29319.72,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12582.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20132.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15099.4,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29319.72},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12582.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24922.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26973.41},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18245.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12582.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25165.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12582.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12582.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12834.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12582.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17615.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15728.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14590.18,"10th_percentile":14590.18,"90th_percentile":14590.18,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16298.64,"10th_percentile":16298.64,"90th_percentile":17101.77,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14752.29,"10th_percentile":14752.29,"90th_percentile":14752.29,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4881.18,"maximum":11191.15,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4881.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7809.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5857.42,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11191.15},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4881.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9512.82},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10295.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7077.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4881.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9762.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4881.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4881.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4978.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4881.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6833.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6101.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7235.8,"maximum":17190.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11577.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8682.96,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17190.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14612.1},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15814.44},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10491.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14471.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7380.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10130.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9044.75,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8554.52,"10th_percentile":8554.52,"90th_percentile":8554.52,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9556.45,"10th_percentile":9556.45,"90th_percentile":9556.45,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9646.02,"10th_percentile":9646.02,"90th_percentile":9646.02,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8016.75,"10th_percentile":8016.75,"90th_percentile":8016.75,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":28255.35,"10th_percentile":28255.35,"90th_percentile":28255.35},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9533.87,"10th_percentile":9533.87,"90th_percentile":9533.87,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5134.09,"10th_percentile":5134.09,"90th_percentile":5134.09,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":20218.47,"10th_percentile":20218.47,"90th_percentile":20218.47},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9505.02,"10th_percentile":9505.02,"90th_percentile":9505.02,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8128.44,"10th_percentile":7904.93,"90th_percentile":9778.96,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8777.88,"10th_percentile":8648.79,"90th_percentile":16957.66,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8498.24,"10th_percentile":7645.22,"90th_percentile":11291.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22161.2,"10th_percentile":22161.2,"90th_percentile":22161.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13735.15,"10th_percentile":13735.15,"90th_percentile":13735.15,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10311.22,"10th_percentile":10311.22,"90th_percentile":10311.22,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14037.94,"maximum":31399.17,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14037.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22460.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16845.53,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31399.17},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14037.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26690.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28886.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20355.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14037.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28075.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14037.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14037.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14318.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14037.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19653.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17547.42,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11900.49,"maximum":26909.22,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11900.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19040.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14280.59,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26909.22},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11900.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22873.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24755.81},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11900.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23800.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11900.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11900.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12138.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11900.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16660.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14875.61,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vagina, Cervix And Vulva Procedures Without Cc/Mcc","code_information":[{"code":"747","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5889.62,"maximum":15348.46,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5889.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9423.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7067.54,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15348.46},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5889.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13046.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14120.2},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8539.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5889.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11779.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5889.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5889.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6007.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5889.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8245.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7362.02,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9504.09,"maximum":21890.55,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15206.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11404.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21890.55},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18607.65},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20138.76},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13780.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19008.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9694.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13305.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11880.11,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12103.84,"10th_percentile":12103.84,"90th_percentile":12103.84,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17590.07,"maximum":41595.59,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17590.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28144.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21108.08,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":41595.59},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17590.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":35357.54},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":38266.91},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25505.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17590.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35180.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17590.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17590.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17941.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17590.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24626.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21987.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10110.38,"maximum":20722.27,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10110.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16176.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12132.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20722.27},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10110.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17614.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19063.97},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14660.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10110.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20220.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10110.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10110.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10110.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14154.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12637.98,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10311.32,"10th_percentile":10311.32,"90th_percentile":10311.32,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12617.09,"maximum":29073.84,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20187.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15140.51,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29073.84},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24713.67},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26747.21},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18294.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25234.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12869.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17663.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15771.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9916.21,"10th_percentile":9916.21,"90th_percentile":9916.21,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":61722.81,"maximum":134023.8,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61722.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98756.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74067.37,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":134023.8},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61722.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":113924.4},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":123298.56},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":89498.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61722.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":123445.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61722.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61722.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62957.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61722.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86411.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77153.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":49453.06,"maximum":114076.11,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49453.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79124.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59343.67,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":114076.11},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49453.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":96968.24},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":104947.18},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":71706.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49453.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98906.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49453.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49453.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50442.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49453.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69234.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61816.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10278.23,"maximum":24839.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10278.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16445.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12333.88,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24839.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10278.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21114.26},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22851.63},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14903.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10278.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20556.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10278.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10278.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10483.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10278.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14389.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12847.79,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14988.83,"maximum":36689.42,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14988.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23982.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17986.6,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":36689.42},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14988.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31187.15},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":33753.35},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21733.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14988.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29977.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14988.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14988.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15288.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14988.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20984.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18736.04,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":18910.39,"10th_percentile":18910.39,"90th_percentile":18910.39,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":28451.3,"maximum":65358.3,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28451.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45522.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34141.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":65358.3},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28451.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":55556.59},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":60128.01},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":41254.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28451.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56902.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28451.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28451.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29020.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28451.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39831.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35564.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36138.26,"10th_percentile":36138.26,"90th_percentile":36138.26,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9587.67,"maximum":23611.65,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9587.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15340.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11505.2,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23611.65},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9587.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20070.64},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21722.13},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13902.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9587.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19175.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9587.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9587.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9587.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13422.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11984.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Without Cc/Mcc","code_information":[{"code":"419","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9356.8,"maximum":21173.83,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14970.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11228.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21173.83},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17998.42},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19479.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13567.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18713.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9543.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13099.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11696.0,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":14456.59,"10th_percentile":14456.59,"90th_percentile":14456.59,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20798.83,"10th_percentile":20798.83,"90th_percentile":22442.83,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":10977.35,"10th_percentile":10977.35,"90th_percentile":10977.35,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":12014.94,"10th_percentile":12014.94,"90th_percentile":12014.94},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10360.67,"10th_percentile":10360.67,"90th_percentile":10360.67,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12473.51,"10th_percentile":12473.51,"90th_percentile":12473.51,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12245.13,"10th_percentile":12245.13,"90th_percentile":12245.13,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10653.09,"10th_percentile":10653.09,"90th_percentile":10653.09,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11769.75,"10th_percentile":11769.75,"90th_percentile":11769.75,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15797.52,"10th_percentile":15797.52,"90th_percentile":15797.52,"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."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. 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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":"Passport Health Plan","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21283.39,"10th_percentile":21283.39,"90th_percentile":21322.47,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":38228.82,"10th_percentile":38228.82,"90th_percentile":38228.82},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19214.52,"10th_percentile":19214.52,"90th_percentile":19832.91,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19847.85,"10th_percentile":19847.85,"90th_percentile":19847.85,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9339.67,"maximum":22019.11,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9339.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14943.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11207.6,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22019.11},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9339.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18716.93},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20257.04},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13542.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9339.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18679.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9339.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9339.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9526.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9339.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13075.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11674.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":12693.89,"10th_percentile":12693.89,"90th_percentile":12693.89,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14158.51,"maximum":31786.46,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22653.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16990.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31786.46},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27019.48},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29242.75},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20529.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28317.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14441.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19821.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17698.14,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18874.67,"10th_percentile":18874.67,"90th_percentile":18874.67,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17782.84,"10th_percentile":17782.84,"90th_percentile":17782.84,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15993.37,"10th_percentile":15993.37,"90th_percentile":15993.37,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24406.6,"maximum":56302.85,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24406.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39050.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29287.92,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":56302.85},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24406.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":47859.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":51797.22},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35389.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24406.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48813.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24406.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24406.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24894.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24406.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34169.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30508.25,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11375.72,"maximum":26714.77,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11375.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18201.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13650.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26714.77},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11375.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22708.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24576.92},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16494.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11375.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22751.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11375.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11375.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11603.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11375.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15926.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14219.65,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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With Cc","code_information":[{"code":"412","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14403.77,"maximum":34253.21,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23046.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17284.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34253.21},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29116.29},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31512.1},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20885.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28807.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14691.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20165.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18004.71,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":22630.19,"maximum":45260.38,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22630.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36208.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27156.23,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":43973.95},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22630.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":37379.22},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":40454.94},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":32813.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22630.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45260.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22630.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22630.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23082.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22630.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31682.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28287.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Without Cc/Mcc","code_information":[{"code":"410","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10876.99,"maximum":24924.57,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17403.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13052.39,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24924.57},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21186.66},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22929.98},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15771.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21753.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11094.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15227.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13596.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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With Cc","code_information":[{"code":"409","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14916.21,"maximum":33687.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23865.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17899.45,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":33687.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":28635.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":30991.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21628.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29832.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15214.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20882.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18645.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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With Mcc","code_information":[{"code":"408","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24427.15,"maximum":56262.68,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24427.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39083.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29312.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":56262.68},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24427.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":47825.03},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":51760.26},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35419.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24427.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48854.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24427.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24427.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24915.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24427.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34198.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30533.94,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":25588.39,"10th_percentile":25588.39,"90th_percentile":25588.39,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":37477.21,"maximum":87234.39,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37477.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59963.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44972.65,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":87234.39},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37477.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":74151.94},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":80253.47},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":54341.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37477.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74954.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37477.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37477.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38226.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37477.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52468.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46846.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7842.09,"maximum":18064.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7842.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12547.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9410.51,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18064.29},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7842.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15355.21},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16618.69},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11371.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7842.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15684.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7842.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7842.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7998.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7842.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10978.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9802.61,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":16440.66,"10th_percentile":16440.66,"90th_percentile":16440.66},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9984.79,"10th_percentile":9984.79,"90th_percentile":9984.79,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9086.16,"10th_percentile":9086.16,"90th_percentile":9086.16,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10369.34,"maximum":24318.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10369.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16590.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12443.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24318.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10369.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20671.68},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22372.63},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15035.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10369.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10369.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10369.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10576.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10369.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14517.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12961.68,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22163.33,"10th_percentile":22163.33,"90th_percentile":22163.33,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13147.4,"10th_percentile":13147.4,"90th_percentile":13147.4,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42531.4,"10th_percentile":42531.4,"90th_percentile":42531.4,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13823.34,"10th_percentile":13823.34,"90th_percentile":13823.34,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12579.24,"10th_percentile":12579.24,"90th_percentile":12579.24,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11584.3,"10th_percentile":11584.3,"90th_percentile":11584.3,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":16406.94,"maximum":39815.03,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16406.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26251.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19688.33,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":39815.03},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16406.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":33844.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":36628.84},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":23790.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16406.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32813.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16406.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16406.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16735.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16406.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22969.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20508.68,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21688.74,"10th_percentile":21688.74,"90th_percentile":21688.74,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":22653.46,"10th_percentile":22653.46,"90th_percentile":22653.46,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4446.16,"maximum":10226.95,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7113.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5335.39,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10226.95},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8693.22},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9408.54},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6446.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8892.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4535.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4446.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6224.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5557.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5654.34,"10th_percentile":5654.34,"90th_percentile":5654.34,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10226.95,"10th_percentile":10226.95,"90th_percentile":10226.95,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5145.42,"10th_percentile":5145.42,"90th_percentile":5145.42,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6410.28,"maximum":15126.69,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10256.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7692.34,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15126.69},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12858.16},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13916.18},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9294.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12820.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8974.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8012.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":28166.27,"10th_percentile":28166.27,"90th_percentile":28166.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8363.35,"10th_percentile":8363.35,"90th_percentile":8363.35,"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":"1 through 10","median_amount":6957.14,"10th_percentile":6957.14,"90th_percentile":7630.48,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12622.55,"10th_percentile":12622.55,"90th_percentile":12622.55,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5340.87,"maximum":12539.42,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8545.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6409.04,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12539.42},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10658.9},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11535.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7744.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10681.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5447.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7477.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6676.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":11907.33,"10th_percentile":11907.33,"90th_percentile":11907.33},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7186.42,"10th_percentile":7186.42,"90th_percentile":7186.42,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":6000.0,"10th_percentile":6000.0,"90th_percentile":6000.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6440.86,"10th_percentile":6440.86,"90th_percentile":6440.86,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7119.89,"10th_percentile":7119.89,"90th_percentile":7119.89,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4229.26,"10th_percentile":4229.26,"90th_percentile":4229.26,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6308.89,"10th_percentile":6308.89,"90th_percentile":6479.1,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8461.33,"10th_percentile":8461.33,"90th_percentile":8461.33,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7868.63,"10th_percentile":7868.63,"90th_percentile":7868.63,"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."}]}]},{"description":"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc","code_information":[{"code":"391","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8688.85,"maximum":20648.34,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8688.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10426.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20648.34},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8688.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17551.73},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18995.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12598.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8688.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17377.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8688.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8688.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8862.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8688.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12164.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10861.06,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10385.47,"10th_percentile":10385.47,"90th_percentile":10385.47,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11501.2,"10th_percentile":11501.2,"90th_percentile":13765.37,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":3726.83,"maximum":8791.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3726.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5962.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4472.2,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":8791.9},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3726.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":7473.39},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":8088.33},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":5403.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3726.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7453.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3726.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3726.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3801.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3726.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5217.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4658.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3157.51,"10th_percentile":3157.51,"90th_percentile":3157.51,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8939.01,"10th_percentile":8793.5,"90th_percentile":8939.01,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":4564.59,"10th_percentile":4564.59,"90th_percentile":4897.59,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":18120.8,"10th_percentile":18120.8,"90th_percentile":18120.8},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4423.45,"10th_percentile":4423.45,"90th_percentile":4423.45,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4913.54,"10th_percentile":4913.54,"90th_percentile":4913.54,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5410.75,"maximum":12883.32,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5410.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8657.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6492.9,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12883.32},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5410.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10951.22},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11852.33},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7845.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5410.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10821.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5410.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5410.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5518.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5410.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7575.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6763.44,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7177.4,"10th_percentile":7177.4,"90th_percentile":7177.4,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7122.1,"10th_percentile":7122.1,"90th_percentile":7122.1,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7160.48,"10th_percentile":7160.48,"90th_percentile":7160.48,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":29431.2,"10th_percentile":29431.2,"90th_percentile":29431.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7123.02,"10th_percentile":7123.02,"90th_percentile":7123.02,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7223.11,"10th_percentile":7122.1,"90th_percentile":8625.47,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6563.89,"10th_percentile":6563.89,"90th_percentile":6563.89,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6374.38,"10th_percentile":6009.06,"90th_percentile":6817.48,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1205.11,"10th_percentile":1205.11,"90th_percentile":1205.11,"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."}]}]},{"description":"Gastrointestinal Obstruction With Mcc","code_information":[{"code":"388","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10117.24,"maximum":23622.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16187.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12140.69,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23622.9},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20080.2},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21732.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14670.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20234.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10319.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14164.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12646.55,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4667.44,"maximum":10771.72,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7467.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5600.93,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10771.72},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9156.3},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9909.72},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6767.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9334.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4760.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4667.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6534.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5834.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11195.12,"10th_percentile":11195.12,"90th_percentile":11195.12,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5662.16,"10th_percentile":5662.16,"90th_percentile":5662.16,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6688.42,"maximum":15947.87,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10701.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8026.1,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15947.87},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13556.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14671.64},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9698.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13376.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6822.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9363.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8360.52,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":10033.9,"10th_percentile":10033.9,"90th_percentile":10033.9,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13136.86,"10th_percentile":13136.86,"90th_percentile":13136.86,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5856.05,"maximum":13974.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5856.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9369.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7027.26,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13974.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5856.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11878.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12856.17},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8491.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5856.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11712.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5856.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5856.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5973.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5856.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8198.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7320.06,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9458.88,"maximum":20315.69,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9458.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15134.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11350.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20315.69},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9458.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17268.97},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18689.93},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13715.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9458.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18917.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9458.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9458.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9648.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9458.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13242.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11823.6,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5484.74,"maximum":12041.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8775.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6581.69,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12041.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10235.44},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11077.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7952.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10969.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5594.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7678.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6855.92,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":6657.42,"10th_percentile":6657.42,"90th_percentile":6657.42,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12397.86,"maximum":27781.82,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19836.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14877.43,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27781.82},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23615.41},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25558.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17976.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24795.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12645.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17357.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15497.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16219.02,"10th_percentile":16219.02,"90th_percentile":16219.02,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11562.75,"10th_percentile":11562.75,"90th_percentile":11562.75,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7533.81,"maximum":17188.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7533.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12054.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9040.57,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17188.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7533.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14610.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15812.97},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10924.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7533.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15067.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7533.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7533.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7684.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7533.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10547.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9417.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14275.66,"maximum":30703.34,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22841.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17130.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30703.34},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26098.8},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28246.31},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20699.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28551.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14561.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19985.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17844.58,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14472.29,"10th_percentile":13335.49,"90th_percentile":17955.88,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14934.55,"10th_percentile":14934.55,"90th_percentile":14934.55,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13458.01,"10th_percentile":8402.31,"90th_percentile":15250.38,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8002.81,"10th_percentile":8002.81,"90th_percentile":8002.81,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":15327.79,"10th_percentile":15327.79,"90th_percentile":15327.79},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9294.03,"10th_percentile":9294.03,"90th_percentile":9294.03,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":15312.93,"10th_percentile":14696.97,"90th_percentile":15315.32,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13590.5,"10th_percentile":13590.5,"90th_percentile":13590.5,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7383.77,"maximum":16098.93,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7383.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11814.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8860.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16098.93},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7383.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13684.59},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14810.61},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10706.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7383.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14767.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7383.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7383.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7383.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10337.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9229.71,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4720.19,"maximum":11115.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7552.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5664.23,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11115.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9448.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10226.09},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6844.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9440.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4814.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6608.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5900.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":4940.2,"10th_percentile":4940.2,"90th_percentile":4940.2,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":268.31,"10th_percentile":268.31,"90th_percentile":268.31,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Signs And Symptoms With Mcc","code_information":[{"code":"695","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7835.92,"maximum":18122.14,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7835.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12537.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9403.1,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18122.14},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7835.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15404.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16671.92},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11362.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7835.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15671.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7835.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7835.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7992.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7835.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10970.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9794.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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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":"11","median_amount":7173.78,"10th_percentile":4582.2,"90th_percentile":7462.02,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7537.36,"10th_percentile":7537.36,"90th_percentile":8605.64,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7948.96,"maximum":18808.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12718.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9538.75,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18808.33},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15987.66},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17303.19},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11525.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15897.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8107.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11128.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9936.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19066.05,"10th_percentile":19066.05,"90th_percentile":19066.05,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9878.91,"10th_percentile":9781.04,"90th_percentile":10468.96,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"14","median_amount":10355.96,"10th_percentile":6967.73,"90th_percentile":11837.39,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":10148.76,"10th_percentile":10001.76,"90th_percentile":12845.06,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10453.96,"10th_percentile":10453.96,"90th_percentile":10453.96,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5414.17,"maximum":11637.89,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5414.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8662.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6497.0,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11637.89},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5414.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9892.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10706.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7850.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5414.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10828.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5414.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5414.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5522.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5414.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7579.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6767.71,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8417.78,"10th_percentile":8417.78,"90th_percentile":8417.78,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8590.5,"10th_percentile":8590.5,"90th_percentile":8590.5,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10686.2,"10th_percentile":10686.2,"90th_percentile":10686.2,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12356.76,"maximum":30301.59,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12356.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19770.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14828.11,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30301.59},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12356.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25757.3},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27876.71},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17917.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12356.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24713.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12356.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12356.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12603.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12356.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17299.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15445.95,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4112.52,"maximum":9762.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4112.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6580.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4935.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":9762.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4112.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8298.45},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":8981.28},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":5963.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4112.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8225.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4112.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4112.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4194.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4112.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5757.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5140.65,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":13064.49,"10th_percentile":13064.49,"90th_percentile":13064.49},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"1 through 10","median_amount":8858.35,"10th_percentile":8858.35,"90th_percentile":8858.35,"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":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":5254.55,"10th_percentile":5254.55,"90th_percentile":5254.55,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":5316.13,"10th_percentile":5316.13,"90th_percentile":5316.13,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4910.97,"10th_percentile":4910.97,"90th_percentile":4911.8,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5999.92,"maximum":14284.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5999.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9599.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7199.9,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14284.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5999.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12142.37},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13141.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8699.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5999.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11999.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5999.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5999.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6119.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5999.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8399.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7499.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7107.97,"10th_percentile":4857.0,"90th_percentile":7198.62,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7921.72,"10th_percentile":7921.72,"90th_percentile":9510.41,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14284.62,"10th_percentile":9760.92,"90th_percentile":14452.62,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7052.2,"10th_percentile":6837.79,"90th_percentile":8154.7,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7998.47,"10th_percentile":7998.47,"90th_percentile":7998.47,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"14","median_amount":7879.9,"10th_percentile":6373.29,"90th_percentile":8198.7,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7294.02,"10th_percentile":7294.02,"90th_percentile":7294.02,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7897.75,"10th_percentile":7897.75,"90th_percentile":7897.75,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4387.49,"10th_percentile":4387.49,"90th_percentile":4387.49,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":7186.95,"10th_percentile":6289.0,"90th_percentile":8887.04,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7278.61,"10th_percentile":7278.61,"90th_percentile":7278.61,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7897.75,"10th_percentile":6366.56,"90th_percentile":9162.42,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10146.01,"maximum":24137.14,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10146.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16233.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12175.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24137.14},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10146.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20517.32},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22205.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14711.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10146.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20292.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10146.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10146.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10348.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10146.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14204.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12682.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":13375.87,"10th_percentile":12001.08,"90th_percentile":18691.97,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13267.97,"10th_percentile":11732.75,"90th_percentile":14143.29,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18443.64,"10th_percentile":18443.64,"90th_percentile":18443.64,"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."}]}]},{"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":11244.87,"maximum":25152.76,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11244.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17991.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13493.84,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25152.76},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11244.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21380.63},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23139.92},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16305.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11244.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22489.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11244.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11244.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11469.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11244.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15742.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14056.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":16021.24,"maximum":37094.38,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16021.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25633.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19225.49,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":37094.38},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16021.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31531.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":34125.91},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":23230.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16021.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32042.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16021.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16021.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16341.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16021.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22429.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20026.55,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18458.82,"10th_percentile":18458.82,"90th_percentile":18458.82,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23274.77,"10th_percentile":23274.77,"90th_percentile":23274.77,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18978.3,"10th_percentile":18978.3,"90th_percentile":18978.3,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":74633.07,"10th_percentile":74633.07,"90th_percentile":74633.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":19733.94,"10th_percentile":19733.94,"90th_percentile":20669.03,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20620.3,"10th_percentile":20620.3,"90th_percentile":20620.3,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":28784.25,"maximum":67333.3,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28784.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46054.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34541.1,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":67333.3},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28784.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":57235.4},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":61944.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":41737.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28784.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57568.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28784.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28784.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29359.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28784.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40297.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35980.31,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16230.98,"10th_percentile":16230.98,"90th_percentile":16230.98,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":29759.48,"10th_percentile":29759.48,"90th_percentile":29759.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":36664.06,"10th_percentile":36619.96,"90th_percentile":37312.43,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37478.63,"10th_percentile":37478.63,"90th_percentile":37478.63,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7395.42,"maximum":17585.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7395.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11832.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8874.5,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17585.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7395.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14948.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16178.13},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10723.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7395.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14790.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7395.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7395.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7543.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7395.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10353.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9244.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12297.15,"maximum":27698.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12297.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19675.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14756.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27698.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12297.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23544.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25481.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17830.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12297.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24594.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12297.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12297.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12543.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12297.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17216.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15371.44,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6695.27,"maximum":15356.49,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6695.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8034.32,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15356.49},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6695.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13053.5},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14127.59},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9708.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6695.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13390.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6695.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6695.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6829.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6695.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9373.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8369.09,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10632.41,"maximum":24868.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10632.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17011.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12758.89,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24868.33},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10632.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21138.85},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22878.24},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15416.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10632.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21264.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10632.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10632.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10845.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10632.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14885.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13290.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13413.86,"10th_percentile":13413.86,"90th_percentile":13413.86,"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":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20506.95,"10th_percentile":20506.95,"90th_percentile":20506.95,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":42559.05,"10th_percentile":42559.05,"90th_percentile":42559.05,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7093.3,"maximum":16497.46,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7093.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11349.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8511.96,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16497.46},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7093.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14023.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15177.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10285.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7093.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14186.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7093.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7093.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7235.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7093.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9930.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8866.62,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9121.19,"10th_percentile":9121.19,"90th_percentile":9121.19,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9425.54,"10th_percentile":9425.54,"90th_percentile":9425.54,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8300.32,"10th_percentile":8300.32,"90th_percentile":8300.32,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8278.79,"10th_percentile":8278.79,"90th_percentile":8278.79,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9054.68,"maximum":21532.19,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9054.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14487.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10865.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":21532.19},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9054.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18303.03},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19809.08},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13129.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9054.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18109.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9054.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9054.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9235.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9054.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12676.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11318.35,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7261.1,"10th_percentile":7261.1,"90th_percentile":7261.1,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11905.71,"10th_percentile":11905.71,"90th_percentile":11905.71,"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."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12012.13,"10th_percentile":12012.13,"90th_percentile":12012.13,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":17407.15,"maximum":41528.09,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17407.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27851.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20888.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":41528.09},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17407.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":35300.17},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":38204.81},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":25240.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17407.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34814.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17407.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17407.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17755.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17407.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24370.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21758.94,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":25784.22,"10th_percentile":25784.22,"90th_percentile":25784.22,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":56806.62,"10th_percentile":56806.62,"90th_percentile":56806.62,"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":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21116.93,"10th_percentile":21116.93,"90th_percentile":21116.93,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10631.04,"maximum":24167.67,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10631.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12757.25,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24167.67},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10631.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20543.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22233.66},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15415.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10631.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21262.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10631.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10631.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10843.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10631.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14883.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13288.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12536.93,"maximum":29375.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12536.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20059.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15044.32,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29375.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12536.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24970.48},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27025.15},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18178.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12536.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25073.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12536.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12536.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12787.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12536.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17551.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15671.16,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":16038.5,"10th_percentile":16038.5,"90th_percentile":16038.5,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":21811.52,"maximum":52351.24,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34898.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26173.82,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":52351.24},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":44500.18},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":48161.84},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":31626.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43623.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22247.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21811.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30536.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27264.4,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22815.77,"10th_percentile":22815.77,"90th_percentile":22815.77,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":35599.41,"maximum":89577.39,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35599.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56959.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42719.29,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":89577.39},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35599.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":76143.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":82408.97},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":51619.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35599.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71198.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35599.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35599.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36311.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35599.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49839.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44499.26,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":22124.6,"maximum":49354.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22124.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35399.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26549.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":49354.18},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22124.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":41952.59},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":45404.62},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":32080.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22124.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44249.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22124.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22124.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22567.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22124.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30974.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27655.75,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5263.46,"maximum":12518.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5263.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8421.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6316.15,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12518.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5263.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10641.14},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11516.74},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7632.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5263.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10526.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5263.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5263.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5263.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7368.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6579.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":150.72,"10th_percentile":150.72,"90th_percentile":150.72,"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":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7022.05,"maximum":16608.35,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11235.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8426.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16608.35},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14117.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15279.26},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10181.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14044.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7162.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9830.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8777.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9294.28,"10th_percentile":9294.28,"90th_percentile":9294.28,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9181.61,"10th_percentile":9181.61,"90th_percentile":9181.61,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8489.98,"10th_percentile":8489.98,"90th_percentile":8489.98,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11277.07,"maximum":26632.81,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11277.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18043.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13532.48,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26632.81},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11277.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22638.72},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24501.52},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16351.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11277.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22554.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11277.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11277.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11502.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11277.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15787.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14096.34,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9742.5,"maximum":19944.48,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15588.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11691.0,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19944.48},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16953.43},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18348.42},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14126.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19485.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9937.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13639.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12178.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11027.0,"10th_percentile":11027.0,"90th_percentile":11027.0,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5331.28,"maximum":12558.71,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5331.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8530.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6397.54,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12558.71},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5331.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10675.29},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11553.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7730.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5331.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10662.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5331.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5331.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5437.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5331.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7463.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6664.1,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6942.63,"10th_percentile":5230.73,"90th_percentile":7027.53,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7107.11,"10th_percentile":7107.11,"90th_percentile":7107.11,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":28975.3,"10th_percentile":28975.3,"90th_percentile":28975.3},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7107.11,"10th_percentile":7107.11,"90th_percentile":7107.11,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7123.64,"10th_percentile":6942.63,"90th_percentile":7380.25,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6317.79,"10th_percentile":6249.74,"90th_percentile":6467.47,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6214.74,"10th_percentile":6214.74,"90th_percentile":7254.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11799.09,"10th_percentile":11799.09,"90th_percentile":11799.09,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13913.54,"10th_percentile":11799.09,"90th_percentile":14785.74,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4255.71,"maximum":10069.46,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6809.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5106.85,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10069.46},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8559.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9263.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6170.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8511.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4340.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4255.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5957.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5319.64,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":22995.03,"10th_percentile":22995.03,"90th_percentile":22995.03},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6139.67,"maximum":14739.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9823.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7367.6,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14739.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12528.95},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13559.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8902.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12279.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6262.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8595.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7674.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8259.44,"10th_percentile":6747.34,"90th_percentile":9726.82,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5859.04,"10th_percentile":5859.04,"90th_percentile":5859.04,"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":"Diabetes With Mcc","code_information":[{"code":"637","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9842.52,"maximum":23402.74,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9842.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15748.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11811.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23402.74},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9842.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19893.06},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21529.94},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14271.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9842.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19685.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9842.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9842.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10039.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9842.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13779.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12303.15,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":11274.13,"10th_percentile":6331.54,"90th_percentile":13039.47,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17862.05,"10th_percentile":17806.51,"90th_percentile":20155.54,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":23124.39,"10th_percentile":23124.39,"90th_percentile":23124.39,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18729.14,"10th_percentile":18729.14,"90th_percentile":18729.14,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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. Procedures Without C","code_information":[{"code":"828","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11672.36,"maximum":25757.0,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11672.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18675.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14006.83,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25757.0},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11672.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21894.25},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23695.8},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16924.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11672.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23344.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11672.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11672.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11905.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11672.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14590.45,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":21648.47,"maximum":49553.45,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34637.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25978.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":49553.45},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":42121.98},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":45587.94},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":31390.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43296.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30307.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27060.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10310.43,"maximum":23500.77,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16496.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12372.52,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23500.77},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19976.38},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21620.12},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14950.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20620.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10516.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14434.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12888.04,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2767.23,"10th_percentile":2767.23,"90th_percentile":2767.23,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":6042.89,"10th_percentile":6042.89,"90th_percentile":6042.89,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8354.53,"maximum":20420.15,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8354.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13367.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10025.44,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20420.15},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8354.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17357.76},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18786.03},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12114.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8354.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16709.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8354.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8354.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8521.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8354.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11696.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10443.16,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6922.03,"maximum":16902.43,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11075.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8306.44,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16902.43},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14367.59},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15549.81},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10036.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13844.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9690.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8652.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6921.75,"10th_percentile":6921.75,"90th_percentile":6921.75,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13665.94,"maximum":30422.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21865.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16399.13,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30422.12},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25859.75},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27987.59},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19815.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27331.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13939.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19132.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17082.42,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":15217.68,"10th_percentile":15217.68,"90th_percentile":15217.68,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16912.32,"10th_percentile":16912.32,"90th_percentile":16912.32,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8340.14,"maximum":19205.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8340.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13344.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10008.17,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19205.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8340.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16325.07},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17668.36},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12093.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8340.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16680.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8340.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8340.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8506.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8340.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11676.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10425.18,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14178.62,"10th_percentile":14178.62,"90th_percentile":14178.62,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5834.13,"maximum":13445.77,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5834.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9334.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7000.96,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13445.77},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5834.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11429.32},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12369.77},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8459.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5834.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11668.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5834.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5834.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5950.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5834.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8167.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7292.66,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11947.47,"10th_percentile":11947.47,"90th_percentile":11947.47,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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 With Mcc","code_information":[{"code":"853","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33833.27,"maximum":80374.11,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33833.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54133.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40599.92,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":80374.11},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33833.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":68320.49},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":73942.18},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":49058.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33833.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67666.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33833.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33833.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34509.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33833.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47366.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42291.59,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":30132.63,"10th_percentile":30132.63,"90th_percentile":30132.63},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":39992.25,"10th_percentile":23527.89,"90th_percentile":40592.72,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44541.4,"10th_percentile":42605.79,"90th_percentile":85000.29,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":107189.26,"10th_percentile":54759.42,"90th_percentile":249056.12,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":62057.78,"10th_percentile":62057.78,"90th_percentile":62057.78,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":43451.07,"10th_percentile":42576.67,"90th_percentile":62680.25,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":45103.03,"10th_percentile":44435.82,"90th_percentile":136765.0,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"46","median_amount":44059.63,"10th_percentile":23132.33,"90th_percentile":58730.13,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":298069.25,"10th_percentile":298069.25,"90th_percentile":298069.25},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14677.08,"10th_percentile":14677.08,"90th_percentile":64147.29,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":44435.82,"10th_percentile":44435.82,"90th_percentile":45103.03,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44708.73,"10th_percentile":44708.73,"90th_percentile":44708.73,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23527.89,"10th_percentile":23527.89,"90th_percentile":23527.89,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23527.86,"10th_percentile":23527.86,"90th_percentile":23527.86,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":276415.33,"10th_percentile":276415.33,"90th_percentile":276415.33},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":78130.02,"10th_percentile":78130.02,"90th_percentile":78130.02,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"23","median_amount":45060.98,"10th_percentile":32559.4,"90th_percentile":54329.65,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":40436.77,"10th_percentile":40436.6,"90th_percentile":46098.62,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44435.83,"10th_percentile":34242.71,"90th_percentile":45984.01,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":63836.85,"10th_percentile":63836.85,"90th_percentile":63836.85,"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."}]}]},{"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":13688.55,"maximum":32111.07,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13688.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21901.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16426.26,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":32111.07},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13688.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27295.41},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29541.39},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19848.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13688.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27377.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13688.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13688.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13962.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13688.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19163.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17110.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":12183.5,"10th_percentile":7029.04,"90th_percentile":17883.67,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17752.83,"10th_percentile":17752.83,"90th_percentile":17752.83,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10105.85,"10th_percentile":10105.85,"90th_percentile":10105.85,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10105.84,"10th_percentile":10105.84,"90th_percentile":11861.7,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":17574.88,"10th_percentile":17574.88,"90th_percentile":17574.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17752.83,"10th_percentile":17752.83,"90th_percentile":17752.83,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14021.46,"10th_percentile":14021.46,"90th_percentile":16490.45,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16155.95,"10th_percentile":16155.08,"90th_percentile":16605.82,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11985.89,"10th_percentile":11985.89,"90th_percentile":11985.89,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10256.99,"maximum":26121.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10256.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16411.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12308.39,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26121.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10256.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22204.33},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24031.39},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14872.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10256.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20513.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10256.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10256.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10462.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10256.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14359.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12821.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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 With Mcc","code_information":[{"code":"856","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31162.15,"maximum":72496.59,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31162.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49859.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37394.58,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":72496.59},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31162.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":61624.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":66695.06},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":45185.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31162.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62324.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31162.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31162.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31785.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31162.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43627.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38952.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":76573.33,"10th_percentile":76573.33,"90th_percentile":76573.33},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":50106.45,"10th_percentile":50106.45,"90th_percentile":87640.01,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":66617.68,"10th_percentile":66617.68,"90th_percentile":66617.68},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":41542.17,"10th_percentile":41542.17,"90th_percentile":41542.17,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17616.88,"10th_percentile":17616.88,"90th_percentile":17616.88,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19962.34,"10th_percentile":19962.34,"90th_percentile":19962.34,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14807.6,"10th_percentile":14807.6,"90th_percentile":14896.76,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8608.22,"10th_percentile":8608.22,"90th_percentile":8608.22,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":16555.91,"10th_percentile":15405.6,"90th_percentile":19496.56,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14866.36,"10th_percentile":14866.3,"90th_percentile":15156.42,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15545.6,"10th_percentile":15545.6,"90th_percentile":15545.6,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative And Post-Traumatic Infections Without Mcc","code_information":[{"code":"863","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6836.4,"maximum":16068.39,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10938.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8203.68,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16068.39},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13658.63},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14782.52},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9912.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13672.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6973.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9570.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8545.5,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":7218.34,"10th_percentile":7218.34,"90th_percentile":7218.34,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10456.78,"10th_percentile":10456.78,"90th_percentile":10456.78,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4772.71,"10th_percentile":4772.71,"90th_percentile":4772.71,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":56264.35,"10th_percentile":56264.35,"90th_percentile":56264.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8883.96,"10th_percentile":8883.96,"90th_percentile":8883.96,"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":"1 through 10","median_amount":11078.33,"10th_percentile":11078.33,"90th_percentile":11078.33,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8084.4,"10th_percentile":8084.4,"90th_percentile":8084.4,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9291.59,"10th_percentile":9291.59,"90th_percentile":9291.59,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6081.44,"maximum":14429.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9730.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7297.73,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14429.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12265.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13274.55},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8818.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12162.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6203.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6081.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8514.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7601.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7377.51,"10th_percentile":7377.51,"90th_percentile":7377.51,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13763.68,"10th_percentile":13763.68,"90th_percentile":13763.68,"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."}]}]},{"description":"Viral Illness With Mcc","code_information":[{"code":"865","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10264.53,"maximum":23717.71,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16423.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12317.44,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23717.71},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20160.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21819.71},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14883.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20529.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10469.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10264.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14370.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12830.66,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13224.98,"10th_percentile":13224.98,"90th_percentile":13224.98,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":11311.14,"10th_percentile":11311.14,"90th_percentile":11311.14,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5957.44,"maximum":14217.13,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5957.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9531.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7148.93,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14217.13},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5957.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12085.0},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13079.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8638.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5957.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11914.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5957.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5957.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6076.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5957.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8340.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7446.8,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14289.27,"10th_percentile":14289.27,"90th_percentile":14289.27,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7040.86,"10th_percentile":7040.86,"90th_percentile":7040.86,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14340.06,"maximum":34457.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14340.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22944.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17208.07,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34457.29},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14340.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29289.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31699.85},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20793.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14340.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14340.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14340.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14626.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14340.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20076.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17925.08,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":213509.99,"10th_percentile":213509.99,"90th_percentile":213509.99,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":64442.34,"10th_percentile":64442.34,"90th_percentile":64442.34,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":47351.24,"maximum":111790.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47351.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75761.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56821.49,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":111790.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47351.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":95025.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":102844.9},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":68659.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47351.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94702.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47351.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47351.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48298.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47351.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66291.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59189.05,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":28019.87,"10th_percentile":28019.87,"90th_percentile":55626.75,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":62141.94,"10th_percentile":62141.94,"90th_percentile":62141.94,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":101872.74,"10th_percentile":101872.74,"90th_percentile":101872.74,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":28877.4,"10th_percentile":28877.4,"90th_percentile":28877.4,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":61919.95,"10th_percentile":60909.69,"90th_percentile":90339.4,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":115934.98,"10th_percentile":115934.98,"90th_percentile":115934.98,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":60237.42,"10th_percentile":55564.53,"90th_percentile":62226.09,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22821.69,"10th_percentile":22821.69,"90th_percentile":22821.69,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":29418.7,"10th_percentile":29418.7,"90th_percentile":29418.7,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":65468.98,"10th_percentile":65468.98,"90th_percentile":88460.86,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":61807.49,"10th_percentile":61807.49,"90th_percentile":61807.49,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":63557.62,"10th_percentile":61761.38,"90th_percentile":84106.73,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":56244.82,"10th_percentile":52729.52,"90th_percentile":56245.06,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":61954.33,"10th_percentile":59739.48,"90th_percentile":70169.43,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13307.64,"maximum":31534.16,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13307.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21292.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15969.17,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31534.16},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13307.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26805.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29010.64},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19296.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13307.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26615.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13307.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13307.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13573.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13307.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18630.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16634.55,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":66276.06,"10th_percentile":66276.06,"90th_percentile":66276.06},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"1 through 10","median_amount":28628.3,"10th_percentile":28628.3,"90th_percentile":28628.3,"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":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21175.44,"10th_percentile":21175.44,"90th_percentile":31530.95,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"206","median_amount":15385.6,"10th_percentile":6842.21,"90th_percentile":18091.52,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":17432.98,"10th_percentile":17432.98,"90th_percentile":17434.83,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18120.42,"10th_percentile":18120.42,"90th_percentile":18935.75,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9640.82,"10th_percentile":9640.82,"90th_percentile":9640.82,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16263.63,"10th_percentile":16263.63,"90th_percentile":16263.63,"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":"Unicare","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":47536.74,"10th_percentile":23521.56,"90th_percentile":146915.5},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":17432.98,"10th_percentile":7115.5,"90th_percentile":17740.38,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"119","median_amount":16546.85,"10th_percentile":7475.33,"90th_percentile":20635.65,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"108","median_amount":15864.01,"10th_percentile":15864.01,"90th_percentile":16143.75,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"59","median_amount":15596.3,"10th_percentile":10495.37,"90th_percentile":17568.31,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25044.1,"10th_percentile":25044.1,"90th_percentile":25044.1,"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."}]}]},{"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":7010.41,"maximum":16568.17,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7010.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11216.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8412.49,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16568.17},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7010.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14083.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15242.3},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10165.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7010.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14020.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7010.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7010.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7150.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7010.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9814.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8763.01,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":15838.54,"10th_percentile":15838.54,"90th_percentile":15838.54},{"payer_name":"Aetna","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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12104.21,"10th_percentile":12104.21,"90th_percentile":12104.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6578.12,"maximum":15404.7,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6578.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10524.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7893.74,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15404.7},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6578.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13094.48},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14171.94},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9538.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6578.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13156.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6578.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6578.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6709.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6578.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9209.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8222.65,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":8595.75,"10th_percentile":8595.75,"90th_percentile":8595.75,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9219.84,"10th_percentile":9219.84,"90th_percentile":9219.84,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8573.07,"10th_percentile":8573.07,"90th_percentile":8573.07,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6445.9,"maximum":14689.59,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10313.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7735.08,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14689.59},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12486.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13514.05},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9346.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12891.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6574.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9024.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8057.38,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7787.72,"10th_percentile":7787.72,"90th_percentile":7787.72,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13470.69,"maximum":29832.35,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13470.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21553.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16164.83,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29832.35},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13470.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25358.42},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27445.02},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19532.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13470.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26941.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13470.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13470.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13740.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13470.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18858.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16838.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11022.22,"maximum":26838.51,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17635.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13226.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26838.51},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22813.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24690.76},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15982.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22044.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11242.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15431.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13777.78,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":12503.43,"10th_percentile":12503.43,"90th_percentile":12503.43,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":11000.0,"10th_percentile":11000.0,"90th_percentile":11000.0},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8875.68,"10th_percentile":8875.68,"90th_percentile":8875.68,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy","code_information":[{"code":"895","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9697.97,"maximum":23267.75,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15516.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11637.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23267.75},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19778.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21405.75},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14062.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9891.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13577.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12122.46,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11955.3,"maximum":28617.46,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11955.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19128.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14346.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":28617.46},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11955.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24325.73},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26327.35},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17335.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11955.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23910.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11955.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11955.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12194.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11955.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16737.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14944.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":14068.8,"10th_percentile":14068.8,"90th_percentile":14068.8},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":213012.08,"10th_percentile":213012.08,"90th_percentile":213012.08,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15242.39,"10th_percentile":15242.39,"90th_percentile":15242.39,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12293.12,"10th_percentile":12293.12,"90th_percentile":14792.8,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15982.78,"10th_percentile":761.94,"90th_percentile":16022.5,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8875.68,"10th_percentile":8875.68,"90th_percentile":8875.68,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridements For Injuries With Cc","code_information":[{"code":"902","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13115.82,"maximum":30491.22,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13115.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20985.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15738.98,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":30491.22},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13115.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":25918.48},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28051.16},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19017.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13115.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26231.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13115.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13115.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13378.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13115.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18362.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16394.78,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":20778.85,"10th_percentile":20778.85,"90th_percentile":20778.85,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15342.51,"10th_percentile":15342.51,"90th_percentile":15342.51,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8012.68,"maximum":19589.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8012.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12820.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9615.22,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19589.33},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8012.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16651.54},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18021.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11618.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8012.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16025.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8012.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8012.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8172.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8012.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11217.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10015.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":25163.61,"maximum":62044.66,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25163.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40261.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30196.33,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":62044.66},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25163.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":52739.89},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":57079.55},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":36487.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25163.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50327.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25163.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25163.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25666.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25163.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35229.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31454.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10162.45,"maximum":26484.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10162.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16259.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12194.94,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26484.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10162.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22513.05},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24365.51},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14735.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10162.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20324.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10162.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10162.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10162.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14227.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12703.06,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13456.99,"maximum":35071.17,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13456.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21531.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16148.39,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":35071.17},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13456.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29811.58},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":32264.6},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":19512.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13456.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26913.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13456.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13456.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13726.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13456.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18839.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16821.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":15805.28,"10th_percentile":15805.28,"90th_percentile":15805.28,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":41669.5,"10th_percentile":41669.5,"90th_percentile":41669.5,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":66983.88,"10th_percentile":66983.88,"90th_percentile":115209.07,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":60277.11,"10th_percentile":60277.11,"90th_percentile":60277.11,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":35669.36,"10th_percentile":35669.36,"90th_percentile":35669.36,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":35394.6,"10th_percentile":35394.6,"90th_percentile":35394.6,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":32209.09,"10th_percentile":32209.09,"90th_percentile":32209.09,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. 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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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":18060.75,"10th_percentile":18060.75,"90th_percentile":18060.75,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19065.29,"10th_percentile":19065.29,"90th_percentile":19065.29,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10909.59,"10th_percentile":10909.59,"90th_percentile":10909.59,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8993.02,"maximum":20379.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14388.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10791.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20379.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17323.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18749.07},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13039.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17986.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9172.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12590.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11241.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":11587.05,"10th_percentile":11587.05,"90th_percentile":11587.05,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10699.55,"10th_percentile":10699.55,"90th_percentile":10699.55,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11198.29,"maximum":26004.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11198.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17917.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13437.95,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26004.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11198.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22104.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23923.47},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16237.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11198.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22396.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11198.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11198.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11422.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11198.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15677.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13997.86,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11520.28,"maximum":27926.45,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11520.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18432.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13824.34,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27926.45},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11520.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23738.35},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":25691.64},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16704.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11520.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23040.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11520.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11520.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11750.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11520.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16128.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14400.35,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11042.96,"10th_percentile":11042.96,"90th_percentile":11042.96,"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4564.68,"maximum":10670.48,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4564.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7303.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5477.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10670.48},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4564.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9070.24},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9816.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6618.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4564.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9129.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4564.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4564.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4564.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6390.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5705.85,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5900.43,"10th_percentile":5900.43,"90th_percentile":5900.43,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10744.77,"maximum":26348.37,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17191.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12893.72,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26348.37},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22396.94},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24239.85},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15579.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21489.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10959.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15042.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13430.96,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15853.54,"10th_percentile":7073.59,"90th_percentile":31045.65,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7958.09,"10th_percentile":7958.09,"90th_percentile":14603.11,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26349.98,"10th_percentile":26349.98,"90th_percentile":26349.98,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16338.72,"10th_percentile":16338.72,"90th_percentile":16338.72,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17022.49,"10th_percentile":17022.49,"90th_percentile":17022.49,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14568.5,"10th_percentile":14323.82,"90th_percentile":14568.5,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13353.38,"10th_percentile":12441.98,"90th_percentile":14299.79,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9431.57,"10th_percentile":9431.57,"90th_percentile":9431.57,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8623.3,"10th_percentile":8623.3,"90th_percentile":8623.3,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14568.5,"10th_percentile":14568.5,"90th_percentile":37598.98,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6537.89,"10th_percentile":6537.89,"90th_percentile":6537.89,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6537.88,"10th_percentile":6537.88,"90th_percentile":6537.88,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14567.67,"10th_percentile":14567.67,"90th_percentile":14567.67,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14568.5,"10th_percentile":13469.93,"90th_percentile":14943.93,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13257.34,"10th_percentile":13034.68,"90th_percentile":40995.94,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15692.98,"10th_percentile":15692.98,"90th_percentile":15692.98,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5871.81,"maximum":14212.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5871.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9394.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7046.17,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14212.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5871.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12080.9},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13074.97},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8514.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5871.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11743.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5871.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5871.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5989.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5871.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8220.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7339.76,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":8909.29,"10th_percentile":8909.29,"90th_percentile":8909.29},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7859.54,"10th_percentile":7859.54,"90th_percentile":7859.54,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7039.48,"10th_percentile":7039.48,"90th_percentile":7039.48,"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":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7859.54,"10th_percentile":7859.54,"90th_percentile":7859.54,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":7092.26,"10th_percentile":7092.26,"90th_percentile":8091.01,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12542.41,"maximum":29302.04,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20067.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15050.89,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29302.04},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24907.64},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26957.15},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18186.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25084.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12793.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17559.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15678.01,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complications Of Treatment With Cc","code_information":[{"code":"920","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6866.54,"maximum":16323.91,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10986.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8239.85,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16323.91},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13875.83},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15017.59},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9956.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13733.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7003.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9613.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8583.18,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16069.79,"10th_percentile":16069.79,"90th_percentile":16069.79,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9047.56,"10th_percentile":9047.56,"90th_percentile":9047.56,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":8717.76,"10th_percentile":8717.76,"90th_percentile":8717.76,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":10899.95,"10th_percentile":10899.95,"90th_percentile":10899.95,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4716.08,"maximum":11049.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4716.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7545.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5659.3,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11049.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4716.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9392.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10165.48},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6838.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4716.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9432.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4716.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4716.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4810.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4716.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6602.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5895.1,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":268.31,"10th_percentile":268.31,"90th_percentile":268.31,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5608.08,"10th_percentile":5608.08,"90th_percentile":5608.08,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc","code_information":[{"code":"922","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11984.76,"maximum":27145.44,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14381.71,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":27145.44},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":23074.47},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24973.13},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17377.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23969.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12224.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16778.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14980.95,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9061.67,"10th_percentile":9061.67,"90th_percentile":9061.67,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":146267.63,"maximum":381225.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":146267.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":234028.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":175521.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":381225.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":146267.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":324053.45},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":350717.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":212088.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":146267.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":292535.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":146267.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":146267.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":149192.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":146267.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":204774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":182834.54,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15144.34,"maximum":34481.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15144.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24230.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18173.21,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":34481.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15144.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":29310.26},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":31722.03},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21959.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15144.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30288.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15144.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15144.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15447.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15144.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21202.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18930.42,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19065.12,"10th_percentile":19065.12,"90th_percentile":19065.12,"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14112.61,"maximum":35294.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14112.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22580.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16935.13,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":35294.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14112.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":30001.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":32470.1},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20463.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14112.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28225.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14112.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14112.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14394.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14112.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19757.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17640.76,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":7097.05,"10th_percentile":7097.05,"90th_percentile":7097.05,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":24248.7,"10th_percentile":24248.7,"90th_percentile":24248.7,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13891.33,"maximum":31403.99,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13891.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22226.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16669.6,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":31403.99},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13891.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":26694.37},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":28890.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20142.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13891.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27782.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13891.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13891.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14169.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13891.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19447.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17364.16,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10609.12,"maximum":24529.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16974.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12730.94,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24529.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20850.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22566.3},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15383.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21218.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10821.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14852.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13261.4,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7856.48,"maximum":17940.55,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12570.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9427.78,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17940.55},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15250.02},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16504.86},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11391.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15712.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8013.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10999.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9820.6,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8696.38,"maximum":20667.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8696.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13914.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10435.66,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20667.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8696.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17568.13},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":19013.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12609.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8696.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17392.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8696.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8696.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8870.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8696.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12174.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10870.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":94838.07,"10th_percentile":94838.07,"90th_percentile":94838.07,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32572.72,"10th_percentile":32572.72,"90th_percentile":32572.72,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":16959.8,"10th_percentile":16959.8,"90th_percentile":16959.8,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14837.95,"10th_percentile":14837.95,"90th_percentile":14837.95,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23112.33,"10th_percentile":23112.33,"90th_percentile":23112.33,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5484.05,"maximum":12767.62,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8774.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6580.86,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":12767.62},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":10852.87},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":11745.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7951.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10968.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5593.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7677.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6855.06,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44974.92,"10th_percentile":44974.92,"90th_percentile":44974.92,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":9450.0,"10th_percentile":5979.85,"90th_percentile":39515.97,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14582.72,"10th_percentile":6423.71,"90th_percentile":23316.78,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25737.44,"10th_percentile":8727.56,"90th_percentile":34155.59,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8150.38,"maximum":17337.92,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13040.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9780.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17337.92},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14737.77},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15950.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11818.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16300.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8313.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11410.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10187.98,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4103.37,"10th_percentile":4103.37,"90th_percentile":4103.37,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4300.24,"maximum":9418.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4300.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6880.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5160.29,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":9418.63},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4300.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8006.13},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":8664.9},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6235.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4300.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8600.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4300.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4300.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4386.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4300.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6020.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5375.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":6075.0,"10th_percentile":6075.0,"90th_percentile":6075.0,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":25032.85,"10th_percentile":25032.85,"90th_percentile":25032.85},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4125.24,"10th_percentile":4125.24,"90th_percentile":4125.24,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14837.95,"10th_percentile":14837.95,"90th_percentile":14837.95,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":3809.04,"maximum":9110.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3809.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6094.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4570.85,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":9110.08},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3809.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":7743.85},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":8381.05},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":5523.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3809.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7618.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3809.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3809.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3885.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3809.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5332.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4761.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy For Multiple Significant Trauma","code_information":[{"code":"955","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":46113.3,"maximum":109724.35,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46113.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73781.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55335.96,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":109724.35},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46113.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":93269.11},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":100943.67},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":66864.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46113.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":92226.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46113.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46113.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47035.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46113.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64558.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57641.62,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":74172.28,"10th_percentile":74172.28,"90th_percentile":74172.28},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":25779.49,"maximum":61422.75,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25779.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41247.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30935.39,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":61422.75},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25779.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":52211.25},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":56507.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":37380.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25779.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51558.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25779.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25779.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26295.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25779.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36091.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32224.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":34366.55,"10th_percentile":34366.55,"90th_percentile":37079.7,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34139.12,"10th_percentile":34042.15,"90th_percentile":34146.42,"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":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":25902.98,"10th_percentile":25902.98,"90th_percentile":25902.98,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":30904.94,"10th_percentile":30904.94,"90th_percentile":30904.94,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32192.1,"10th_percentile":32192.1,"90th_percentile":32192.1,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. 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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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":37470.18,"10th_percentile":37470.18,"90th_percentile":37470.18,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":20169.39,"maximum":42484.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20169.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32271.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24203.27,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":42484.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20169.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":36112.94},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":39084.46},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":29245.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20169.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40338.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20169.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20169.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20572.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20169.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28237.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25211.74,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":18728.67,"maximum":43655.76,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18728.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29965.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22474.4,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":43655.76},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18728.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":37108.76},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":40162.21},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27156.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18728.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37457.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18728.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18728.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19103.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18728.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26220.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23410.84,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":24137.49,"10th_percentile":24137.49,"90th_percentile":24137.49,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22126.22,"10th_percentile":22126.22,"90th_percentile":22126.22,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21965.12,"10th_percentile":21965.12,"90th_percentile":21965.12,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21965.12,"10th_percentile":21965.12,"90th_percentile":21965.12,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10499.51,"maximum":24108.21,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10499.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16799.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12599.41,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24108.21},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10499.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20492.73},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22178.96},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15224.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10499.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20999.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10499.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10499.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10709.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10499.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14699.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13124.39,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":45085.75,"10th_percentile":45085.75,"90th_percentile":45085.75,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":13404.59,"10th_percentile":13404.59,"90th_percentile":13404.59,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":13580.83,"10th_percentile":13503.25,"90th_percentile":30356.13},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13740.48,"10th_percentile":13740.48,"90th_percentile":13740.48,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12128.68,"10th_percentile":12128.68,"90th_percentile":12128.68,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6443.16,"maximum":14663.88,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10309.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7731.79,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14663.88},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12464.75},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13490.4},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9342.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12886.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6572.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9020.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8053.95,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":19771.36,"maximum":47985.02,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19771.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31634.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23725.63,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":47985.02},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19771.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":40788.76},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":44145.02},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":28668.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19771.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39542.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19771.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19771.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20166.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19771.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27679.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24714.2,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8871.76,"maximum":22840.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14194.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10646.11,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22840.29},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19414.96},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21012.5},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12864.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17743.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9049.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12420.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11089.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12628.94,"10th_percentile":12628.94,"90th_percentile":12628.94,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6184.2,"maximum":16116.6,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9894.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7421.04,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16116.6},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13699.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14826.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":8967.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12368.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6307.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8657.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7730.25,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8890.26,"maximum":23169.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8890.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14224.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10668.31,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23169.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8890.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19694.99},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21315.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12890.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8890.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17780.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8890.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8890.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9068.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8890.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12446.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11112.82,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":32142.5,"maximum":76401.6,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32142.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51428.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38571.0,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":76401.6},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32142.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":64943.74},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":70287.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":46606.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32142.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64285.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32142.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32142.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32785.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32142.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44999.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40178.12,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":38013.95,"10th_percentile":38013.95,"90th_percentile":38013.95,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":50922.02,"10th_percentile":50922.02,"90th_percentile":50922.02,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":50922.02,"10th_percentile":50922.02,"90th_percentile":50922.02,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":94023.84,"10th_percentile":94023.84,"90th_percentile":94023.84,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42467.59,"10th_percentile":42467.59,"90th_percentile":42467.59,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":42972.15,"10th_percentile":40915.4,"90th_percentile":96011.31,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":68039.59,"10th_percentile":68039.59,"90th_percentile":68039.59,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49950.89,"10th_percentile":49950.89,"90th_percentile":49950.89,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":16842.65,"maximum":39347.4,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16842.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26948.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20211.18,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":39347.4},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16842.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":33446.51},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":36198.62},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":24421.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16842.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33685.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16842.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16842.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17179.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16842.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23579.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21053.31,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39344.18,"10th_percentile":38644.18,"90th_percentile":74096.14,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":18091.68,"10th_percentile":18091.68,"90th_percentile":18091.68,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21752.8,"10th_percentile":21752.8,"90th_percentile":21752.8,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21695.27,"10th_percentile":21695.27,"90th_percentile":21695.27,"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":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":42421.54,"10th_percentile":42421.54,"90th_percentile":42421.54,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":19987.05,"10th_percentile":19987.05,"90th_percentile":19987.05},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":20959.88,"10th_percentile":20959.88,"90th_percentile":20959.88,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. 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Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":15364.76,"10th_percentile":15364.76,"90th_percentile":15364.76,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":13910.32,"10th_percentile":13910.32,"90th_percentile":13910.32,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15282.64,"10th_percentile":15282.64,"90th_percentile":15282.64,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8215.46,"maximum":18567.28,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8215.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13144.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9858.55,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":18567.28},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8215.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15782.76},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":17081.43},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11912.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8215.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16430.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8215.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8215.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8379.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8215.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11501.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10269.32,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":14116.72,"maximum":32112.68,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22586.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16940.06,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":32112.68},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":27296.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":29542.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":20469.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28233.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14399.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19763.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17645.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10060.37,"maximum":24374.98,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10060.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16096.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12072.44,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24374.98},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10060.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20719.49},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22424.37},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14587.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10060.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20120.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10060.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10060.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10261.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10060.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14084.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12575.46,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":24544.98,"maximum":63969.85,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24544.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39271.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29453.98,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":63969.85},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24544.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":54376.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":58850.67},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":35590.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24544.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49089.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24544.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24544.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25035.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24544.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34362.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30681.22,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12397.18,"maximum":29218.47,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19835.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14876.62,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29218.47},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24836.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":26880.27},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":17975.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24794.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12645.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12397.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17356.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15496.48,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9769.9,"maximum":22072.15,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9769.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15631.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11723.88,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22072.15},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9769.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18762.01},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20305.82},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14166.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9769.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19539.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9769.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9769.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9965.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9769.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13677.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12212.38,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":12569.82,"maximum":29353.46,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20111.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15083.78,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":29353.46},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":24951.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":27004.45},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18226.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25139.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12821.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17597.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15712.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26819.4,"10th_percentile":26819.4,"90th_percentile":30149.43,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5765.13,"10th_percentile":5765.13,"90th_percentile":6368.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5176.08,"10th_percentile":5176.08,"90th_percentile":5701.81,"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":"Magellan","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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":12368.34,"10th_percentile":12368.34,"90th_percentile":12368.34},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6368.67,"10th_percentile":6368.67,"90th_percentile":6368.67,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"11","median_amount":22373.16,"10th_percentile":5897.5,"90th_percentile":27096.88},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":5593.93,"10th_percentile":5593.93,"90th_percentile":6563.58,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":5662.31,"10th_percentile":5662.31,"90th_percentile":6157.3,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":2031.16,"10th_percentile":2031.16,"90th_percentile":2031.16,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"21","median_amount":17455.01,"10th_percentile":8911.08,"90th_percentile":23646.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":5662.31,"10th_percentile":5662.31,"90th_percentile":6157.3,"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."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6435.37,"10th_percentile":6435.37,"90th_percentile":6435.37,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7765.69,"10th_percentile":7765.69,"90th_percentile":7765.69,"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."}]}]},{"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":15125.84,"maximum":36806.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15125.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24201.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18151.01,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":36806.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15125.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":31286.86},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":33861.27},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":21932.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15125.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30251.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15125.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15125.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15428.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15125.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21176.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18907.3,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21562.24,"10th_percentile":21562.24,"90th_percentile":21562.24,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":8672.41,"maximum":19902.7,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8672.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13875.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10406.89,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19902.7},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8672.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16917.91},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18309.98},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":12574.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8672.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17344.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8672.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8672.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8845.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8672.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12141.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10840.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":15529.84,"10th_percentile":15529.84,"90th_percentile":15529.84},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":8664.21,"10th_percentile":8664.21,"90th_percentile":12597.14,"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":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12565.49,"10th_percentile":12565.49,"90th_percentile":12565.49,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6290.39,"maximum":14831.0,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6290.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10064.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7548.47,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":14831.0},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6290.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":12606.81},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":13644.15},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9121.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6290.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12580.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6290.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6290.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6416.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6290.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8806.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7862.99,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7215.01,"10th_percentile":7215.01,"90th_percentile":8244.01,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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","code_information":[{"code":"616","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23891.42,"maximum":62108.94,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23891.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38226.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28669.7,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":62108.94},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23891.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":52794.53},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":57138.68},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":34642.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23891.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47782.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23891.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23891.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24369.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23891.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33447.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29864.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31906.13,"10th_percentile":31906.13,"90th_percentile":31906.13,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":33007.4,"10th_percentile":33007.4,"90th_percentile":33007.4,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9586.3,"maximum":23026.7,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15338.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11503.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23026.7},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19573.41},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21183.99},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13900.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19172.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9778.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13420.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11982.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6209.55,"maximum":13889.3,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6209.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9935.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7451.46,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":13889.3},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6209.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":11806.34},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":12777.81},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9003.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6209.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12419.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6209.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6209.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6333.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6209.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8693.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7761.94,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12945.02,"10th_percentile":12945.02,"90th_percentile":12945.02,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6887.34,"10th_percentile":6887.34,"90th_percentile":6887.34,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10366.6,"maximum":25874.31,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10366.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16586.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12439.92,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":25874.31},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10366.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21993.97},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":23803.72},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15031.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10366.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20733.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10366.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10366.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10573.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10366.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14513.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12958.25,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":14706.05,"10th_percentile":14706.05,"90th_percentile":14706.05,"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":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9809.64,"maximum":22742.26,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15695.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11771.57,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22742.26},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":19331.63},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20922.32},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14223.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19619.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10005.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9809.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13733.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12262.05,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12102.2,"10th_percentile":12102.2,"90th_percentile":12102.2,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5174.54,"10th_percentile":5174.54,"90th_percentile":5174.54,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6902.16,"maximum":15836.99,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8282.59,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15836.99},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13461.93},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14569.63},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10008.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13804.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7040.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6902.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9663.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8627.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":3908.37,"maximum":10186.77,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3908.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6253.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4690.04,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10186.77},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3908.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":8659.07},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9371.58},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":5667.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3908.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7816.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3908.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3908.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3986.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3908.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5471.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":4885.46,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7341.3,"maximum":17617.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11746.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8809.56,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17617.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14975.46},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16207.7},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10644.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14682.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7488.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7341.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10277.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9176.62,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2850.69,"10th_percentile":2850.69,"90th_percentile":2850.69,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":11576.45,"maximum":23152.9,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11576.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18522.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13891.74,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":22329.27},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11576.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":18980.57},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":20542.37},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":16785.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11576.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23152.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11576.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11576.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11807.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11576.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16207.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14470.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7452.23,"10th_percentile":7452.23,"90th_percentile":7452.23,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9481.69,"10th_percentile":9481.69,"90th_percentile":9481.69,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9481.67,"10th_percentile":9481.67,"90th_percentile":9481.67,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6869.28,"maximum":17289.71,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6869.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10990.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8243.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17289.71},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6869.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14696.79},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15906.11},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9960.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6869.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13738.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6869.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6869.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7006.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6869.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9616.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8586.6,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"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":8185.06,"10th_percentile":8185.06,"90th_percentile":8185.06,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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","code_information":[{"code":"776","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4485.21,"maximum":11464.34,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4485.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7176.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5382.25,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11464.34},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4485.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9745.04},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10546.91},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6503.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4485.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8970.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4485.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4485.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4574.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4485.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6279.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5606.51,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16366.79,"10th_percentile":16366.79,"90th_percentile":16366.79,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5456.49,"10th_percentile":5456.49,"90th_percentile":5456.49,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9622.34,"10th_percentile":9622.34,"90th_percentile":9622.34,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17419.56,"10th_percentile":14037.15,"90th_percentile":17419.56,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8097.5,"10th_percentile":8097.5,"90th_percentile":8097.5,"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":"Passport Health Plan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14357.05,"10th_percentile":14357.05,"90th_percentile":14357.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14357.05,"10th_percentile":14357.05,"90th_percentile":14357.05,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15064.48,"10th_percentile":15064.48,"90th_percentile":15064.48,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7650.95,"maximum":17063.13,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12241.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9181.14,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17063.13},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":14504.19},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15697.65},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11093.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15301.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7803.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10711.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9563.69,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9433.94,"10th_percentile":9433.94,"90th_percentile":10199.46,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":14945.14,"10th_percentile":14480.65,"90th_percentile":33909.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":9433.94,"10th_percentile":9433.94,"90th_percentile":9433.98,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10199.46,"10th_percentile":10199.46,"90th_percentile":10199.46,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9230.82,"10th_percentile":9230.82,"90th_percentile":9230.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8038.13,"10th_percentile":8038.13,"90th_percentile":8038.13,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":26447.61,"10th_percentile":25687.8,"90th_percentile":31816.78},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11546.89,"10th_percentile":11546.89,"90th_percentile":11546.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16459.04,"10th_percentile":16459.04,"90th_percentile":16459.04,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":4482.15,"10th_percentile":4482.15,"90th_percentile":4482.15},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16015.84,"10th_percentile":16015.84,"90th_percentile":16015.84,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":41332.31,"10th_percentile":41332.31,"90th_percentile":41332.31},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":14574.41,"10th_percentile":14574.41,"90th_percentile":14977.73,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":40717.63,"maximum":95536.15,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40717.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65148.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48861.16,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":95536.15},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40717.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":81208.7},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":87890.88},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":59040.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40717.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81435.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40717.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40717.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41531.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40717.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57004.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50897.04,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":52818.7,"10th_percentile":52818.7,"90th_percentile":52818.7,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":32464.46,"10th_percentile":3968.78,"90th_percentile":33362.87,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36071.63,"10th_percentile":36071.63,"90th_percentile":36071.63,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":39598.41,"10th_percentile":14368.95,"90th_percentile":67548.26,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36071.63,"10th_percentile":36071.63,"90th_percentile":36071.63,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19456.09,"10th_percentile":19456.09,"90th_percentile":19456.09,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":26151.88,"10th_percentile":26151.88,"90th_percentile":26151.88,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":36071.63,"10th_percentile":23002.95,"90th_percentile":36071.63,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3968.77,"10th_percentile":3968.77,"90th_percentile":3968.77,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":24135.46,"10th_percentile":24135.46,"90th_percentile":24135.46},{"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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12986.84,"10th_percentile":12986.84,"90th_percentile":12986.84,"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."}]}]},{"description":"Prematurity Without Major Problems","code_information":[{"code":"792","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16778.94,"maximum":39368.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16778.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26846.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20134.73,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":39368.29},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16778.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":33464.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":36217.84},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":24329.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16778.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33557.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16778.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16778.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17114.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16778.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23490.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20973.68,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8634.04,"10th_percentile":6073.6,"90th_percentile":10832.0,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":815.4,"10th_percentile":815.4,"90th_percentile":815.4,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21765.23,"10th_percentile":21765.23,"90th_percentile":22367.95,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":19806.36,"10th_percentile":19806.36,"90th_percentile":20354.84,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12896.84,"10th_percentile":12896.84,"90th_percentile":12896.84,"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."}]}]},{"description":"Full Term Neonate With Major Problems","code_information":[{"code":"793","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28565.02,"maximum":67021.54,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28565.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45704.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34278.02,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":67021.54},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28565.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":56970.4},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":61658.15},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":41419.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28565.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57130.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28565.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28565.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29136.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28565.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39991.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35706.28,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8271.21,"10th_percentile":8271.21,"90th_percentile":8271.21,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11378.68,"10th_percentile":6351.46,"90th_percentile":26210.7,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":37054.29,"10th_percentile":12259.51,"90th_percentile":37054.29,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":10111.07,"maximum":23722.53,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10111.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16177.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12133.28,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":23722.53},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10111.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":20164.89},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":21824.14},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":14661.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10111.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20222.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10111.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10111.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10313.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10111.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14155.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12638.84,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":9809.23,"10th_percentile":9809.23,"90th_percentile":9809.23},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"1 through 10","median_amount":2138.68,"10th_percentile":2138.68,"90th_percentile":2138.68},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1872.3,"10th_percentile":1872.3,"90th_percentile":1929.6,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":11165.0,"10th_percentile":5777.0,"90th_percentile":13115.88,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":2478.2,"10th_percentile":2478.2,"90th_percentile":3336.64},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1929.6,"10th_percentile":1872.3,"90th_percentile":6351.46,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":10134.84,"10th_percentile":1775.2,"90th_percentile":13115.82,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":890.61,"10th_percentile":890.61,"90th_percentile":890.61,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":815.4,"10th_percentile":815.4,"90th_percentile":984.04,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":6121.13,"10th_percentile":4013.62,"90th_percentile":8415.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":13115.82,"10th_percentile":1775.19,"90th_percentile":13479.04,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"98","median_amount":11935.4,"10th_percentile":11935.4,"90th_percentile":12265.93,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12065.84,"10th_percentile":12065.84,"90th_percentile":12065.84,"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."}]}]},{"description":"Normal Newborn","code_information":[{"code":"795","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":1368.79,"maximum":3210.79,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1368.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":2190.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":1642.55,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":3210.79},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1368.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":2729.27},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":2953.84},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":1984.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1368.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":2737.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1368.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1368.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1396.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1368.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":1916.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":1710.99,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":8161.79,"10th_percentile":8161.79,"90th_percentile":8161.79},{"payer_name":"Aetna","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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"129","median_amount":2595.79,"10th_percentile":2247.55,"90th_percentile":3210.79,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1929.6,"10th_percentile":1872.3,"90th_percentile":1929.6,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1605.39,"10th_percentile":1605.39,"90th_percentile":2046.95,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2568.63,"10th_percentile":2568.63,"90th_percentile":3210.79,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1872.3,"10th_percentile":1872.3,"90th_percentile":1872.3,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":5613.5,"10th_percentile":5613.5,"90th_percentile":5613.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1872.3,"10th_percentile":1872.3,"90th_percentile":1872.3,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":2910.04,"10th_percentile":1747.1,"90th_percentile":9853.33},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"27","median_amount":1872.3,"10th_percentile":1872.3,"90th_percentile":1929.6,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":1775.2,"10th_percentile":1775.19,"90th_percentile":1824.73,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":815.4,"10th_percentile":815.4,"90th_percentile":815.4,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":815.4,"10th_percentile":815.4,"90th_percentile":815.4,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"18","median_amount":3660.86,"10th_percentile":1775.2,"90th_percentile":6670.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"39","median_amount":1775.19,"10th_percentile":1775.19,"90th_percentile":1872.3,"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"255","median_amount":1615.42,"10th_percentile":1615.42,"90th_percentile":1660.5,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3206.1,"10th_percentile":3206.1,"90th_percentile":3206.1,"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."}]}]},{"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":7994.86,"maximum":20514.96,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7994.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12791.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9593.83,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":20514.96},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7994.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":17438.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18873.25},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":11592.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7994.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15989.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7994.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7994.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8154.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7994.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11192.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9993.58,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6853.52,"maximum":15558.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6853.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10965.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8224.22,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15558.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6853.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13225.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14313.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9937.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6853.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13707.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6853.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6853.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6990.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6853.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9594.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8566.9,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6556.88,"maximum":15558.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6556.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10491.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7868.26,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":15558.97},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6556.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13225.61},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14313.87},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":9507.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6556.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13113.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6556.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6556.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6688.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6556.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9179.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8196.1,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3188.68,"10th_percentile":3188.68,"90th_percentile":3188.68,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7828.11,"10th_percentile":7828.11,"90th_percentile":7828.11,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":31026.51,"maximum":76404.82,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31026.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49642.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37231.81,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":76404.82},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31026.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":64946.47},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":70290.53},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":44988.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31026.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62053.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31026.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31026.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31647.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31026.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43437.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38783.14,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":56037.7,"10th_percentile":56037.7,"90th_percentile":56037.7,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":53643.04,"10th_percentile":53643.04,"90th_percentile":53643.04},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":42245.71,"10th_percentile":42245.71,"90th_percentile":42245.71,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":19246.59,"maximum":46821.55,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19246.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30794.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23095.91,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":46821.55},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19246.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":39799.78},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":43074.66},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":27907.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19246.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19246.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19246.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19631.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19246.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26945.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24058.24,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":13077.46,"maximum":26382.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20923.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15692.95,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":26382.12},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":22425.62},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":24270.89},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":18962.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26154.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13339.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18308.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16346.82,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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 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":9289.66,"maximum":18579.32,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9289.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14863.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11147.59,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":17765.39},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9289.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":15101.13},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":16343.71},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13470.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9289.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18579.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9289.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9289.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9475.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9289.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13005.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11612.08,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":7393.36,"maximum":16036.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7393.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11829.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8872.03,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16036.25},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7393.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13631.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":14752.95},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10720.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7393.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14786.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7393.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7393.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7541.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7393.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10350.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9241.7,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8867.08,"10th_percentile":8867.08,"90th_percentile":8867.08,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16037.86,"10th_percentile":15909.55,"90th_percentile":17342.74,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8867.08,"10th_percentile":8867.08,"90th_percentile":8867.08,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6563.58,"10th_percentile":6563.58,"90th_percentile":6563.58,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9856.08,"10th_percentile":9856.08,"90th_percentile":9856.08,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7991.93,"10th_percentile":7991.93,"90th_percentile":8867.08,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":5165.49,"maximum":11626.65,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5165.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8264.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6198.59,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":11626.65},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5165.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9883.01},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":10696.22},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":7489.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5165.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10330.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5165.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5165.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5268.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5165.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7231.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6456.86,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6428.22,"10th_percentile":6428.22,"90th_percentile":6429.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. 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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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH 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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2386.59,"10th_percentile":2386.59,"90th_percentile":2386.59,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":35924.34,"10th_percentile":35924.34,"90th_percentile":35924.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":6429.09,"10th_percentile":6368.67,"90th_percentile":6429.09,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5850.47,"10th_percentile":5850.47,"90th_percentile":5850.47,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"63","median_amount":5850.47,"10th_percentile":5152.73,"90th_percentile":5850.5,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10425.7,"10th_percentile":10425.7,"90th_percentile":10425.7,"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."}]}]},{"description":"Coagulation Disorders","code_information":[{"code":"813","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10449.5,"maximum":24874.75,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10449.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16719.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12539.4,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":24874.75},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10449.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":21144.31},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":22884.15},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":15151.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10449.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20899.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10449.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10449.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10658.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10449.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14629.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13061.88,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":6946.69,"maximum":16328.73,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6946.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11114.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8336.03,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":16328.73},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6946.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":13879.93},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":15022.02},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":10072.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6946.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13893.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6946.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6946.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7085.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6946.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9725.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8683.36,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9027.9,"10th_percentile":9027.9,"90th_percentile":9027.9,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8215.43,"10th_percentile":8215.43,"90th_percentile":8215.43,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":4329.69,"maximum":10596.56,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4329.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6927.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5195.63,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":10596.56},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4329.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":9007.4},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":9748.57},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":6278.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4329.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8659.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4329.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4329.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4416.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4329.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6061.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5412.11,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback 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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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":15521.13,"maximum":35342.75,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15521.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24833.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18625.36,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":35342.75},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15521.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":30042.44},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":32514.45},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":22505.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15521.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31042.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15521.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15521.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15831.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15521.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21729.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19401.41,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19541.36,"10th_percentile":19541.36,"90th_percentile":19541.36,"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":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":9244.45,"maximum":19777.35,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14791.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11093.34,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"fee schedule","standard_charge_dollar":19777.35},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"fee schedule","standard_charge_dollar":16811.36},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"fee schedule","standard_charge_dollar":18194.67},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":13404.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18488.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9429.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12942.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11555.56,"additional_payer_notes":"Psych-Case Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9550.38,"10th_percentile":9550.38,"90th_percentile":9550.38,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, bupivacaine liposome","code_information":[{"code":"0763","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":9759.31,"10th_percentile":6460.88,"90th_percentile":30003.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7117.52,"10th_percentile":6651.62,"90th_percentile":7120.7,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4792.19,"10th_percentile":4792.19,"90th_percentile":4792.19,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":32366.22,"10th_percentile":32366.22,"90th_percentile":32366.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5534.39,"10th_percentile":5534.39,"90th_percentile":5534.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5796.0,"10th_percentile":5796.0,"90th_percentile":6556.68,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4645.75,"10th_percentile":4645.75,"90th_percentile":5463.35,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6930.7,"10th_percentile":6930.7,"90th_percentile":6930.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9316.81,"10th_percentile":9316.81,"90th_percentile":9316.81,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":24204.73,"10th_percentile":24204.73,"90th_percentile":24204.73},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9121.78,"10th_percentile":9121.78,"90th_percentile":9121.78,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6923.12,"10th_percentile":6923.12,"90th_percentile":6923.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"12","median_amount":17427.75,"10th_percentile":7794.4,"90th_percentile":27054.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2533.61,"10th_percentile":2533.61,"90th_percentile":2533.61,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":17034.11,"10th_percentile":17034.11,"90th_percentile":17034.11,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3721.11,"10th_percentile":3721.11,"90th_percentile":8386.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6620.64,"10th_percentile":2605.89,"90th_percentile":6928.0,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":27957.14,"10th_percentile":27957.14,"90th_percentile":27957.14},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":35.32,"10th_percentile":35.32,"90th_percentile":35.32,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1186.75,"10th_percentile":1186.75,"90th_percentile":1186.75,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":12709.52,"10th_percentile":12709.52,"90th_percentile":12709.52},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4920.58,"10th_percentile":4920.58,"90th_percentile":4920.58,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":125.96,"10th_percentile":125.96,"90th_percentile":6797.48,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4473.81,"10th_percentile":3303.34,"90th_percentile":4660.03,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, tarlatamab-dlle, 1 mg","code_information":[{"code":"0768","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9354.57,"10th_percentile":9354.57,"90th_percentile":9354.57,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, glycopyrrolate, 0.1 mg","code_information":[{"code":"0792","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1432.09,"10th_percentile":1432.09,"90th_percentile":1432.09,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, methylpred sod succ 5mg","code_information":[{"code":"0801","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":121.84,"10th_percentile":121.84,"90th_percentile":121.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"558","median_amount":195.23,"10th_percentile":76.14,"90th_percentile":203.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"823","median_amount":53.7,"10th_percentile":43.05,"90th_percentile":247.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"18375","median_amount":122.66,"10th_percentile":18.76,"90th_percentile":513.65,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"141","median_amount":118.14,"10th_percentile":5.0,"90th_percentile":853.94},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"505","median_amount":230.29,"10th_percentile":176.89,"90th_percentile":287.0,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12262","median_amount":124.88,"10th_percentile":46.64,"90th_percentile":124.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"292","median_amount":83.46,"10th_percentile":19.32,"90th_percentile":347.2,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"220","median_amount":122.66,"10th_percentile":16.29,"90th_percentile":551.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"180","median_amount":176.91,"10th_percentile":66.08,"90th_percentile":184.77,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"7710","median_amount":53.7,"10th_percentile":43.05,"90th_percentile":230.84,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"30568","median_amount":124.88,"10th_percentile":46.64,"90th_percentile":124.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":247.23,"10th_percentile":247.23,"90th_percentile":247.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"140","median_amount":279.8,"10th_percentile":133.26,"90th_percentile":446.85,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"195","median_amount":231.0,"10th_percentile":143.2,"90th_percentile":1235.2},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"143","median_amount":227.08,"10th_percentile":176.89,"90th_percentile":394.0,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1487","median_amount":252.86,"10th_percentile":64.12,"90th_percentile":1185.84},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1683","median_amount":227.08,"10th_percentile":175.27,"90th_percentile":356.56,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"4634","median_amount":53.7,"10th_percentile":43.05,"90th_percentile":225.25,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"106","median_amount":176.57,"10th_percentile":105.28,"90th_percentile":236.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"16","median_amount":102.28,"10th_percentile":20.2,"90th_percentile":268.5},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"593","median_amount":20.2,"10th_percentile":20.2,"90th_percentile":123.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":99.9,"10th_percentile":37.31,"90th_percentile":125.39,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"2048","median_amount":22.23,"10th_percentile":20.2,"90th_percentile":156.12,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"84","median_amount":150.36,"10th_percentile":120.54,"90th_percentile":701.4},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"4250","median_amount":229.6,"10th_percentile":129.15,"90th_percentile":912.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"40","median_amount":232.49,"10th_percentile":183.16,"90th_percentile":371.95,"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":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"33668","median_amount":54.77,"10th_percentile":43.91,"90th_percentile":229.76,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"8518","median_amount":100.38,"10th_percentile":46.64,"90th_percentile":125.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1865","median_amount":138.46,"10th_percentile":43.31,"90th_percentile":178.4,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":345.01,"10th_percentile":195.01,"90th_percentile":2112.38},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":306.08,"10th_percentile":306.08,"90th_percentile":306.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":87.6,"10th_percentile":87.6,"90th_percentile":133.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"172","median_amount":299.94,"10th_percentile":89.35,"90th_percentile":757.75,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":311.68,"10th_percentile":311.68,"90th_percentile":311.68},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":335.73,"10th_percentile":335.73,"90th_percentile":335.73,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":85.32,"10th_percentile":81.95,"90th_percentile":87.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":234.53,"10th_percentile":234.53,"90th_percentile":234.53,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":299.94,"10th_percentile":299.94,"90th_percentile":299.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":126.24,"10th_percentile":126.24,"90th_percentile":126.24,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":61.83,"10th_percentile":61.83,"90th_percentile":61.83,"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":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"89","median_amount":87.6,"10th_percentile":87.6,"90th_percentile":230.23,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"40","median_amount":85.32,"10th_percentile":50.0,"90th_percentile":87.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1039.5,"10th_percentile":1039.5,"90th_percentile":1039.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":418.42,"10th_percentile":418.42,"90th_percentile":418.42,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"45","median_amount":150.0,"10th_percentile":87.6,"90th_percentile":584.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":235.84,"10th_percentile":210.05,"90th_percentile":335.73,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"60","median_amount":87.6,"10th_percentile":87.6,"90th_percentile":175.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":12.0,"10th_percentile":12.0,"90th_percentile":12.0},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20.0,"10th_percentile":20.0,"90th_percentile":172.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":20.0,"10th_percentile":20.0,"90th_percentile":54.37,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":512.82,"10th_percentile":512.82,"90th_percentile":1113.84},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"20","median_amount":292.0,"10th_percentile":173.76,"90th_percentile":777.44},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"71","median_amount":87.6,"10th_percentile":87.6,"90th_percentile":225.36,"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 ($): FEE SCHEDULE]","count":"46","median_amount":87.06,"10th_percentile":81.95,"90th_percentile":87.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":87.06,"10th_percentile":87.06,"90th_percentile":87.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"412","median_amount":89.35,"10th_percentile":89.35,"90th_percentile":207.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":85.32,"10th_percentile":81.95,"90th_percentile":87.06,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"14","median_amount":96.21,"10th_percentile":73.13,"90th_percentile":121.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Type A ED Visits","code_information":[{"code":"5022","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":633.45,"10th_percentile":614.76,"90th_percentile":1163.4},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"222","median_amount":128.85,"10th_percentile":128.85,"90th_percentile":149.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"30","median_amount":128.85,"10th_percentile":45.66,"90th_percentile":190.98,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":0.54,"10th_percentile":0.54,"90th_percentile":250.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":128.85,"10th_percentile":128.85,"90th_percentile":171.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"178","median_amount":375.01,"10th_percentile":131.43,"90th_percentile":487.39,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":173.12,"10th_percentile":173.12,"90th_percentile":173.12,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"37","median_amount":130.95,"10th_percentile":30.95,"90th_percentile":278.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":221.92,"10th_percentile":221.92,"90th_percentile":375.09,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":49.97,"10th_percentile":42.51,"90th_percentile":49.97,"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":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"94","median_amount":87.6,"10th_percentile":87.6,"90th_percentile":149.28,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"95","median_amount":131.43,"10th_percentile":45.65,"90th_percentile":156.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":246.88,"10th_percentile":246.88,"90th_percentile":246.88,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":267.14,"10th_percentile":267.14,"90th_percentile":267.14,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"21","median_amount":281.43,"10th_percentile":128.85,"90th_percentile":835.2},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":202.75,"10th_percentile":177.86,"90th_percentile":281.36,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"67","median_amount":128.85,"10th_percentile":128.85,"90th_percentile":139.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":50.0,"10th_percentile":50.0,"90th_percentile":50.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":50.0,"10th_percentile":50.0,"90th_percentile":50.0,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"22","median_amount":411.04,"10th_percentile":100.0,"90th_percentile":687.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"68","median_amount":128.85,"10th_percentile":128.85,"90th_percentile":139.2,"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 ($): FEE SCHEDULE]","count":"40","median_amount":128.85,"10th_percentile":30.95,"90th_percentile":156.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"355","median_amount":131.43,"10th_percentile":131.43,"90th_percentile":143.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"28","median_amount":128.85,"10th_percentile":30.95,"90th_percentile":155.95,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"12","median_amount":153.45,"10th_percentile":109.6,"90th_percentile":219.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Type A ED Visits","code_information":[{"code":"5023","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"29","median_amount":1596.39,"10th_percentile":1046.63,"90th_percentile":2688.57},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"952","median_amount":427.09,"10th_percentile":257.51,"90th_percentile":714.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"116","median_amount":268.31,"10th_percentile":160.51,"90th_percentile":443.02,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"18","median_amount":437.69,"10th_percentile":188.06,"90th_percentile":1272.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"60","median_amount":430.33,"10th_percentile":258.29,"90th_percentile":817.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"857","median_amount":1124.99,"10th_percentile":456.71,"90th_percentile":1849.25,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":850.72,"10th_percentile":770.63,"90th_percentile":1676.42},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"29","median_amount":433.72,"10th_percentile":227.08,"90th_percentile":829.24,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"166","median_amount":270.69,"10th_percentile":145.81,"90th_percentile":489.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"11","median_amount":626.08,"10th_percentile":402.52,"90th_percentile":1653.84,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":908.21,"10th_percentile":704.48,"90th_percentile":2180.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":592.77,"10th_percentile":592.77,"90th_percentile":592.77,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","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":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"412","median_amount":418.68,"10th_percentile":285.22,"90th_percentile":726.08,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"422","median_amount":245.83,"10th_percentile":145.81,"90th_percentile":403.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1097.5,"10th_percentile":1097.5,"90th_percentile":1126.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"69","median_amount":357.0,"10th_percentile":227.08,"90th_percentile":795.89,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"271","median_amount":430.33,"10th_percentile":276.14,"90th_percentile":755.63,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":190.66,"10th_percentile":190.66,"90th_percentile":190.66},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"32","median_amount":196.03,"10th_percentile":114.17,"90th_percentile":502.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"91","median_amount":124.29,"10th_percentile":97.75,"90th_percentile":194.52,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":1471.68,"10th_percentile":894.18,"90th_percentile":1855.14},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"72","median_amount":1186.35,"10th_percentile":427.3,"90th_percentile":2252.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"268","median_amount":418.68,"10th_percentile":271.26,"90th_percentile":726.08,"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 ($): FEE SCHEDULE]","count":"267","median_amount":270.51,"10th_percentile":146.8,"90th_percentile":449.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":670.31,"10th_percentile":670.31,"90th_percentile":795.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1675","median_amount":438.93,"10th_percentile":274.41,"90th_percentile":754.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"141","median_amount":260.09,"10th_percentile":145.81,"90th_percentile":445.67,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"41","median_amount":348.35,"10th_percentile":149.68,"90th_percentile":484.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Type A ED Visits","code_information":[{"code":"5024","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"78","median_amount":5097.79,"10th_percentile":2443.05,"90th_percentile":9297.16},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"30","median_amount":988.71,"10th_percentile":549.11,"90th_percentile":1887.09,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"51","median_amount":867.74,"10th_percentile":543.0,"90th_percentile":1635.92,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"2180","median_amount":2843.8,"10th_percentile":1286.5,"90th_percentile":5713.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":2271.73,"10th_percentile":971.8,"90th_percentile":9701.34},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"38","median_amount":744.24,"10th_percentile":371.95,"90th_percentile":933.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"414","median_amount":696.18,"10th_percentile":393.18,"90th_percentile":1148.49,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"35","median_amount":1254.21,"10th_percentile":700.0,"90th_percentile":4145.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"16","median_amount":3700.14,"10th_percentile":2690.22,"90th_percentile":5449.81,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":909.01,"10th_percentile":352.64,"90th_percentile":1396.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"525","median_amount":939.27,"10th_percentile":410.85,"90th_percentile":1741.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1083","median_amount":648.16,"10th_percentile":375.45,"90th_percentile":1033.14,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1827.84,"10th_percentile":1827.84,"90th_percentile":4176.63,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":5727.6,"10th_percentile":5709.11,"90th_percentile":5978.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":669.83,"10th_percentile":294.77,"90th_percentile":766.18,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"424","median_amount":5323.4,"10th_percentile":723.62,"90th_percentile":10470.95},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"106","median_amount":668.74,"10th_percentile":321.51,"90th_percentile":1141.96,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"389","median_amount":987.96,"10th_percentile":506.82,"90th_percentile":1796.35,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":451.16,"10th_percentile":451.16,"90th_percentile":451.16},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"64","median_amount":361.68,"10th_percentile":239.25,"90th_percentile":536.88,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"128","median_amount":293.86,"10th_percentile":215.23,"90th_percentile":438.23,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"15","median_amount":2815.68,"10th_percentile":1587.6,"90th_percentile":5008.08},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"222","median_amount":3253.6,"10th_percentile":1005.0,"90th_percentile":8387.65},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"375","median_amount":974.89,"10th_percentile":449.67,"90th_percentile":1789.1,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"691","median_amount":696.73,"10th_percentile":401.75,"90th_percentile":1065.79,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1131.46,"10th_percentile":1131.46,"90th_percentile":1131.46,"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":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"2280","median_amount":963.9,"10th_percentile":533.25,"90th_percentile":1847.69,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"380","median_amount":669.28,"10th_percentile":375.46,"90th_percentile":1099.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"106","median_amount":693.06,"10th_percentile":355.67,"90th_percentile":1266.57,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"29","median_amount":9338.46,"10th_percentile":4897.82,"90th_percentile":16584.92},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"563","median_amount":1464.88,"10th_percentile":753.04,"90th_percentile":3644.73,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"262","median_amount":1323.19,"10th_percentile":660.42,"90th_percentile":2585.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"11","median_amount":1964.03,"10th_percentile":1027.52,"90th_percentile":3984.16,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"29","median_amount":1638.42,"10th_percentile":935.65,"90th_percentile":4791.92,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"960","median_amount":5697.89,"10th_percentile":2598.3,"90th_percentile":12234.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":12469.24,"10th_percentile":11664.58,"90th_percentile":16915.33},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":1455.48,"10th_percentile":752.45,"90th_percentile":3373.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"338","median_amount":2096.46,"10th_percentile":811.71,"90th_percentile":2570.13,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"21","median_amount":2961.93,"10th_percentile":1609.57,"90th_percentile":5368.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"17","median_amount":5417.52,"10th_percentile":1800.44,"90th_percentile":15227.43,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1485.75,"10th_percentile":1485.75,"90th_percentile":3132.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"313","median_amount":1835.39,"10th_percentile":770.73,"90th_percentile":4193.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"962","median_amount":2144.95,"10th_percentile":663.71,"90th_percentile":2605.89,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1782.89,"10th_percentile":1782.89,"90th_percentile":1782.89,"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":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8188.4,"10th_percentile":8188.4,"90th_percentile":8188.4,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":6898.56,"10th_percentile":6603.35,"90th_percentile":9475.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1299.51,"10th_percentile":933.4,"90th_percentile":2940.68,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"203","median_amount":7531.3,"10th_percentile":1390.21,"90th_percentile":17286.6},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"53","median_amount":1381.33,"10th_percentile":660.13,"90th_percentile":3028.0,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"224","median_amount":1752.59,"10th_percentile":773.37,"90th_percentile":3740.42,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":909.25,"10th_percentile":789.54,"90th_percentile":1509.25,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2083.62,"10th_percentile":2083.62,"90th_percentile":2083.62,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"52","median_amount":767.26,"10th_percentile":680.68,"90th_percentile":1406.5,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"122","median_amount":6493.5,"10th_percentile":2169.6,"90th_percentile":21261.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"219","median_amount":1768.81,"10th_percentile":811.26,"90th_percentile":4151.42,"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":"598","median_amount":1622.37,"10th_percentile":704.52,"90th_percentile":2620.05,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1068","median_amount":1743.91,"10th_percentile":787.36,"90th_percentile":3929.53,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"276","median_amount":1366.33,"10th_percentile":759.99,"90th_percentile":2581.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"70","median_amount":1573.12,"10th_percentile":608.95,"90th_percentile":3665.35,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":2631.5,"10th_percentile":985.05,"90th_percentile":7862.76,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2392.12,"10th_percentile":1626.81,"90th_percentile":6529.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3411.65,"10th_percentile":3411.65,"90th_percentile":3411.65,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"23","median_amount":9970.53,"10th_percentile":4852.98,"90th_percentile":22707.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1706.18,"10th_percentile":1706.18,"90th_percentile":1706.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2387.79,"10th_percentile":1874.44,"90th_percentile":2565.75,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":10072.05,"10th_percentile":10072.05,"90th_percentile":10072.05,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5402.79,"10th_percentile":1615.44,"90th_percentile":7299.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":2358.39,"10th_percentile":1177.38,"90th_percentile":5136.41,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"14","median_amount":10955.46,"10th_percentile":2620.59,"90th_percentile":31784.48},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2910.57,"10th_percentile":2910.57,"90th_percentile":3089.61,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9228.19,"10th_percentile":9228.19,"90th_percentile":9228.19,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1759.42,"10th_percentile":1759.42,"90th_percentile":1759.42,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1579.71,"10th_percentile":1579.71,"90th_percentile":1579.71,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":21268.0,"10th_percentile":16964.0,"90th_percentile":56903.07},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7260.44,"10th_percentile":4802.84,"90th_percentile":8508.9,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":2565.75,"10th_percentile":1781.57,"90th_percentile":6225.46,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":7070.71,"10th_percentile":2521.41,"90th_percentile":12403.91,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2108.39,"10th_percentile":2108.39,"90th_percentile":10675.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2108.43,"10th_percentile":2108.43,"90th_percentile":3167.35,"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."}]}]},{"description":"Trauma Response with Critical Care","code_information":[{"code":"5045","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8212.64,"10th_percentile":6400.49,"90th_percentile":10327.1,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3167.94,"10th_percentile":3167.94,"90th_percentile":3607.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":26678.81,"10th_percentile":24833.28,"90th_percentile":40288.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1647.37,"10th_percentile":1647.37,"90th_percentile":1647.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7147.98,"10th_percentile":7147.98,"90th_percentile":7147.98,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7498.57,"10th_percentile":7498.57,"90th_percentile":10563.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3164.38,"10th_percentile":3016.02,"90th_percentile":4518.1,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2038.73,"10th_percentile":2038.73,"90th_percentile":2038.73,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"22","median_amount":8611.04,"10th_percentile":2168.57,"90th_percentile":17726.63},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5430.51,"10th_percentile":5430.51,"90th_percentile":5430.51,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1751.59,"10th_percentile":1751.59,"90th_percentile":1751.59,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10241.18,"10th_percentile":10241.18,"90th_percentile":10241.18,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3577.3,"10th_percentile":3577.3,"90th_percentile":5860.03,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10863.56,"10th_percentile":6824.8,"90th_percentile":18911.05,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2453.86,"10th_percentile":2453.86,"90th_percentile":2453.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":644.01,"10th_percentile":500.04,"90th_percentile":1218.09},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"34","median_amount":463.8,"10th_percentile":163.5,"90th_percentile":2072.25,"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":"[APC ($): FEE SCHEDULE]","count":"58","median_amount":125.48,"10th_percentile":95.48,"90th_percentile":316.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":193.55,"10th_percentile":193.55,"90th_percentile":193.55,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9595.58,"10th_percentile":9595.58,"90th_percentile":9595.58,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"93","median_amount":646.11,"10th_percentile":224.1,"90th_percentile":1863.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":514.02,"10th_percentile":514.02,"90th_percentile":514.02},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"67","median_amount":158.25,"10th_percentile":122.54,"90th_percentile":408.01,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":578.38,"10th_percentile":511.56,"90th_percentile":685.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"36","median_amount":272.78,"10th_percentile":186.75,"90th_percentile":574.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"182","median_amount":124.88,"10th_percentile":119.57,"90th_percentile":330.75,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1135.8,"10th_percentile":1135.8,"90th_percentile":1135.8,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":101.98,"10th_percentile":101.98,"90th_percentile":101.98,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":2742.4,"10th_percentile":179.0,"90th_percentile":5982.39},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":239.62,"10th_percentile":143.7,"90th_percentile":743.01,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"114","median_amount":125.4,"10th_percentile":122.54,"90th_percentile":321.37,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"109","median_amount":244.1,"10th_percentile":95.32,"90th_percentile":1405.86,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"32","median_amount":125.68,"10th_percentile":90.17,"90th_percentile":318.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":169.36,"10th_percentile":102.73,"90th_percentile":589.47,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1504.19,"10th_percentile":1504.19,"90th_percentile":3012.94},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"128","median_amount":592.2,"10th_percentile":296.1,"90th_percentile":1980.2,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"144","median_amount":482.64,"10th_percentile":309.73,"90th_percentile":899.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2646.42,"10th_percentile":2646.42,"90th_percentile":2646.42,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":592.2,"10th_percentile":592.2,"90th_percentile":800.5,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"207","median_amount":1089.24,"10th_percentile":548.8,"90th_percentile":4748.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":391.81,"10th_percentile":391.81,"90th_percentile":391.81},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":745.08,"10th_percentile":745.08,"90th_percentile":745.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"180","median_amount":480.26,"10th_percentile":303.91,"90th_percentile":891.92,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1639.0,"10th_percentile":1546.44,"90th_percentile":5890.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":533.66,"10th_percentile":429.63,"90th_percentile":710.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"67","median_amount":383.85,"10th_percentile":296.1,"90th_percentile":1866.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"524","median_amount":467.94,"10th_percentile":224.88,"90th_percentile":979.17,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"19","median_amount":987.65,"10th_percentile":368.05,"90th_percentile":4519.41},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":539.27,"10th_percentile":517.59,"90th_percentile":1078.54,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"27","median_amount":435.15,"10th_percentile":258.15,"90th_percentile":1675.22,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":216.2,"10th_percentile":196.0,"90th_percentile":392.0,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":73.38,"10th_percentile":63.58,"90th_percentile":3379.7,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"18","median_amount":1808.8,"10th_percentile":929.44,"90th_percentile":4577.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"58","median_amount":505.16,"10th_percentile":296.1,"90th_percentile":2262.3,"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":"268","median_amount":409.63,"10th_percentile":124.89,"90th_percentile":899.95,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"252","median_amount":388.84,"10th_percentile":302.02,"90th_percentile":1667.55,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"200","median_amount":311.18,"10th_percentile":39.66,"90th_percentile":644.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"27","median_amount":515.27,"10th_percentile":276.54,"90th_percentile":1106.16,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":767.02,"10th_percentile":296.1,"90th_percentile":4990.98,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1311.24,"10th_percentile":466.89,"90th_percentile":1904.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"29","median_amount":3376.42,"10th_percentile":1140.7,"90th_percentile":8757.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":808.41,"10th_percentile":808.41,"90th_percentile":808.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1187.74,"10th_percentile":718.75,"90th_percentile":1367.49,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3410.76,"10th_percentile":3410.76,"90th_percentile":3410.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"25","median_amount":798.84,"10th_percentile":549.07,"90th_percentile":2257.35,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":150.0,"10th_percentile":150.0,"90th_percentile":150.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":4192.35,"10th_percentile":4192.35,"90th_percentile":4192.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7415.92,"10th_percentile":7415.92,"90th_percentile":7415.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":657.87,"10th_percentile":474.54,"90th_percentile":2317.83,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":1449.03,"10th_percentile":302.02,"90th_percentile":8268.22,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":638.82,"10th_percentile":574.44,"90th_percentile":1251.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1025.79,"10th_percentile":1025.79,"90th_percentile":1025.79,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1527.58,"10th_percentile":1527.58,"90th_percentile":1897.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"15","median_amount":5683.52,"10th_percentile":2814.75,"90th_percentile":11202.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1893.22,"10th_percentile":1773.29,"90th_percentile":4223.72,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":3539.86,"10th_percentile":2334.95,"90th_percentile":4619.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1449.19,"10th_percentile":1307.09,"90th_percentile":2190.33,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":856.95,"10th_percentile":856.95,"90th_percentile":2661.11,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":428.12,"10th_percentile":428.12,"90th_percentile":428.12,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":24234.56,"10th_percentile":24234.56,"90th_percentile":24234.56},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5385.67,"10th_percentile":5385.67,"90th_percentile":5385.67,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1660.87,"10th_percentile":1182.97,"90th_percentile":7017.06,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2456.7,"10th_percentile":1582.89,"90th_percentile":5281.53,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1779.83,"10th_percentile":1576.49,"90th_percentile":3358.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Skin Procedures","code_information":[{"code":"5055","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3229.11,"10th_percentile":3229.11,"90th_percentile":3229.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":5628.82,"10th_percentile":5628.82,"90th_percentile":5628.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3255.07,"10th_percentile":3255.07,"90th_percentile":3255.07,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3553.61,"10th_percentile":3553.61,"90th_percentile":3553.61,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2655.94,"10th_percentile":2655.94,"90th_percentile":2655.94,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3574.88,"10th_percentile":3574.88,"90th_percentile":3574.88,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5027.42,"10th_percentile":5027.42,"90th_percentile":5027.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hyperbaric Oxygen","code_information":[{"code":"5061","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":2064.2,"10th_percentile":2039.89,"90th_percentile":26255.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":499.52,"10th_percentile":249.76,"90th_percentile":512.04,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":534.54,"10th_percentile":502.07,"90th_percentile":3131.99,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1306.52,"10th_percentile":607.1,"90th_percentile":6286.7,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":2534.32,"10th_percentile":2220.41,"90th_percentile":4666.21},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"27","median_amount":616.14,"10th_percentile":486.09,"90th_percentile":1983.39,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":681.81,"10th_percentile":412.31,"90th_percentile":1168.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1113.15,"10th_percentile":1113.15,"90th_percentile":1113.15,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":484.7,"10th_percentile":484.7,"90th_percentile":485.04,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"104","median_amount":1654.91,"10th_percentile":907.98,"90th_percentile":4784.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":491.24,"10th_percentile":314.3,"90th_percentile":1000.96,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1804.48,"10th_percentile":1804.48,"90th_percentile":1804.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1008.78,"10th_percentile":1008.78,"90th_percentile":1085.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":513.54,"10th_percentile":479.34,"90th_percentile":2804.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"85","median_amount":636.95,"10th_percentile":216.3,"90th_percentile":1032.76,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1739.21,"10th_percentile":1739.21,"90th_percentile":1739.21,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1925.92,"10th_percentile":1925.92,"90th_percentile":1925.92},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":964.89,"10th_percentile":615.0,"90th_percentile":12642.96},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":924.02,"10th_percentile":924.02,"90th_percentile":1666.0,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":564.84,"10th_percentile":485.04,"90th_percentile":2353.58,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":196.0,"10th_percentile":196.0,"90th_percentile":443.06,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":317.8,"10th_percentile":317.8,"90th_percentile":378.7,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"11","median_amount":4532.46,"10th_percentile":2062.5,"90th_percentile":7788.96},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":542.04,"10th_percentile":473.64,"90th_percentile":3699.65,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"32","median_amount":639.94,"10th_percentile":343.95,"90th_percentile":875.38,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"71","median_amount":596.02,"10th_percentile":483.11,"90th_percentile":2914.03,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":552.78,"10th_percentile":342.43,"90th_percentile":688.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":712.31,"10th_percentile":584.39,"90th_percentile":1363.58,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":5877.5,"10th_percentile":3661.04,"90th_percentile":13445.33},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"52","median_amount":1363.8,"10th_percentile":623.33,"90th_percentile":2680.68,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":1546.87,"10th_percentile":1260.85,"90th_percentile":1664.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2563.38,"10th_percentile":2563.38,"90th_percentile":2695.33,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4011.75,"10th_percentile":4011.75,"90th_percentile":4011.75,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"231","median_amount":2950.68,"10th_percentile":1146.96,"90th_percentile":7378.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":140.0,"10th_percentile":140.0,"90th_percentile":140.0},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2411.13,"10th_percentile":2411.13,"90th_percentile":2411.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"59","median_amount":1541.54,"10th_percentile":1197.07,"90th_percentile":1690.07,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":2004.33,"10th_percentile":1526.79,"90th_percentile":5713.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3587.37,"10th_percentile":3587.37,"90th_percentile":9071.36,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"30","median_amount":1824.76,"10th_percentile":769.38,"90th_percentile":3952.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"170","median_amount":1462.27,"10th_percentile":1079.47,"90th_percentile":1657.62,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6462.97,"10th_percentile":6462.97,"90th_percentile":6462.97,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":5641.14,"10th_percentile":3015.0,"90th_percentile":9838.37},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1846.04,"10th_percentile":1638.84,"90th_percentile":3449.06,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":1196.77,"10th_percentile":735.69,"90th_percentile":2321.19,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":599.13,"10th_percentile":487.22,"90th_percentile":740.79,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":743.55,"10th_percentile":743.55,"90th_percentile":743.55,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":4148.45,"10th_percentile":2956.39,"90th_percentile":9743.03},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"22","median_amount":5634.14,"10th_percentile":2030.0,"90th_percentile":9337.13},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":1596.02,"10th_percentile":735.46,"90th_percentile":2186.74,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"92","median_amount":1571.35,"10th_percentile":1227.07,"90th_percentile":1657.63,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1753.18,"10th_percentile":1753.18,"90th_percentile":1753.18,"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":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"113","median_amount":1331.59,"10th_percentile":575.13,"90th_percentile":2855.25,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"64","median_amount":1337.77,"10th_percentile":1202.57,"90th_percentile":1656.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2202.2,"10th_percentile":1244.61,"90th_percentile":2242.95,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":11543.6,"10th_percentile":11543.6,"90th_percentile":11543.6},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2949.31,"10th_percentile":1422.85,"90th_percentile":8754.95,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":2503.93,"10th_percentile":2218.74,"90th_percentile":2863.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"51","median_amount":5698.26,"10th_percentile":4112.14,"90th_percentile":10261.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":2580.82,"10th_percentile":2405.93,"90th_percentile":2780.93,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2367.39,"10th_percentile":2367.39,"90th_percentile":2367.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2415.93,"10th_percentile":1549.77,"90th_percentile":4951.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"52","median_amount":2479.47,"10th_percentile":2190.33,"90th_percentile":2780.03,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3162.06,"10th_percentile":3162.06,"90th_percentile":3162.06,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":7964.99,"10th_percentile":7964.99,"90th_percentile":7964.99},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3294.53,"10th_percentile":3294.53,"90th_percentile":3294.53,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3113.36,"10th_percentile":1605.09,"90th_percentile":5075.02,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":462.85,"10th_percentile":462.85,"90th_percentile":1449.92,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":4663.54,"10th_percentile":4663.54,"90th_percentile":5310.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3613.08,"10th_percentile":2298.6,"90th_percentile":5843.04,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"30","median_amount":2662.5,"10th_percentile":2347.13,"90th_percentile":6613.83,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":2667.23,"10th_percentile":1594.04,"90th_percentile":3816.4,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":2520.46,"10th_percentile":2405.93,"90th_percentile":2785.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2575.33,"10th_percentile":2575.33,"90th_percentile":2575.33,"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."}]}]},{"description":"Level 1 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5091","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":13144.06,"10th_percentile":13144.06,"90th_percentile":13144.06},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2243.0,"10th_percentile":2243.0,"90th_percentile":5462.27,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6319.52,"10th_percentile":6319.52,"90th_percentile":6319.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"15","median_amount":8858.24,"10th_percentile":5819.44,"90th_percentile":11706.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3717.61,"10th_percentile":3343.21,"90th_percentile":5993.02,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4355.98,"10th_percentile":4355.98,"90th_percentile":4355.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3597.67,"10th_percentile":3033.43,"90th_percentile":5134.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":3717.31,"10th_percentile":3124.25,"90th_percentile":6328.32,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3451.02,"10th_percentile":3451.02,"90th_percentile":3451.02,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1775.7,"10th_percentile":1775.7,"90th_percentile":1775.7,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":15307.09,"10th_percentile":15307.09,"90th_percentile":15307.09},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":42556.25,"10th_percentile":42556.25,"90th_percentile":42556.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2276.22,"10th_percentile":2276.22,"90th_percentile":2276.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3343.21,"10th_percentile":2968.57,"90th_percentile":6322.69,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":2890.27,"10th_percentile":2332.35,"90th_percentile":6056.36,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5055.61,"10th_percentile":5055.61,"90th_percentile":5976.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5092","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":24083.79,"10th_percentile":24083.79,"90th_percentile":24083.79},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12002.39,"10th_percentile":12002.39,"90th_percentile":12002.39,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6054.18,"10th_percentile":6054.18,"90th_percentile":6319.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"20","median_amount":15663.65,"10th_percentile":10522.23,"90th_percentile":25613.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6046.23,"10th_percentile":6046.23,"90th_percentile":6319.53,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":22278.17,"10th_percentile":22278.17,"90th_percentile":22278.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4224.75,"10th_percentile":4224.75,"90th_percentile":4224.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6319.52,"10th_percentile":5888.32,"90th_percentile":16030.83,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":28240.31,"10th_percentile":28240.31,"90th_percentile":28240.31},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13431.65,"10th_percentile":13431.65,"90th_percentile":13431.65,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3506.56,"10th_percentile":3506.56,"90th_percentile":3506.56,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":19711.83,"10th_percentile":19711.83,"90th_percentile":19711.83},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9888.85,"10th_percentile":9888.85,"90th_percentile":9888.85,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6414.35,"10th_percentile":6216.21,"90th_percentile":6511.63,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5209.65,"10th_percentile":4747.4,"90th_percentile":8210.63,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5976.52,"10th_percentile":5976.52,"90th_percentile":5976.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5093","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5094","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":56659.06,"10th_percentile":56659.06,"90th_percentile":56659.06,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21196.98,"10th_percentile":21196.98,"90th_percentile":21196.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Strapping and Cast Application","code_information":[{"code":"5101","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":236.4,"10th_percentile":193.5,"90th_percentile":372.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":127.35,"10th_percentile":127.35,"90th_percentile":127.35,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1239.66,"10th_percentile":1239.66,"90th_percentile":1239.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"14","median_amount":994.82,"10th_percentile":361.58,"90th_percentile":2991.22,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":278.48,"10th_percentile":278.48,"90th_percentile":362.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":269.7,"10th_percentile":256.4,"90th_percentile":543.63,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":124.88,"10th_percentile":124.88,"90th_percentile":124.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":3276.9,"10th_percentile":3276.9,"90th_percentile":3276.9},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":384.15,"10th_percentile":296.85,"90th_percentile":907.86,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":87.11,"10th_percentile":87.11,"90th_percentile":87.11,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":690.38,"10th_percentile":690.38,"90th_percentile":690.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":274.94,"10th_percentile":181.05,"90th_percentile":345.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":120.64,"10th_percentile":120.64,"90th_percentile":222.22,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Strapping and Cast Application","code_information":[{"code":"5102","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1616.96,"10th_percentile":1616.96,"90th_percentile":1616.96},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"40","median_amount":270.03,"10th_percentile":176.63,"90th_percentile":357.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":305.79,"10th_percentile":305.79,"90th_percentile":305.79,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":267.6,"10th_percentile":267.6,"90th_percentile":267.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"49","median_amount":742.04,"10th_percentile":277.78,"90th_percentile":1102.7,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":347.94,"10th_percentile":328.2,"90th_percentile":382.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":50.0,"10th_percentile":50.0,"90th_percentile":50.0,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":679.49,"10th_percentile":679.49,"90th_percentile":679.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":272.85,"10th_percentile":175.05,"90th_percentile":380.66,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"23","median_amount":305.79,"10th_percentile":124.88,"90th_percentile":409.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":1345.71,"10th_percentile":1345.71,"90th_percentile":1345.71},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":399.59,"10th_percentile":399.59,"90th_percentile":399.59,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":337.8,"10th_percentile":337.8,"90th_percentile":354.9,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":232.62,"10th_percentile":232.62,"90th_percentile":232.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":81.72,"10th_percentile":62.11,"90th_percentile":98.14,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":1407.2,"10th_percentile":1407.2,"90th_percentile":1407.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":364.71,"10th_percentile":175.05,"90th_percentile":788.88,"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":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":290.0,"10th_percentile":224.89,"90th_percentile":387.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"47","median_amount":278.31,"10th_percentile":205.94,"90th_percentile":423.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":387.99,"10th_percentile":387.99,"90th_percentile":981.66,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":385.3,"10th_percentile":385.3,"90th_percentile":385.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Musculoskeletal Procedures","code_information":[{"code":"5111","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1127.76,"10th_percentile":1127.76,"90th_percentile":9331.95},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"40","median_amount":204.38,"10th_percentile":145.2,"90th_percentile":976.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":357.33,"10th_percentile":285.85,"90th_percentile":919.2,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"45","median_amount":708.86,"10th_percentile":296.98,"90th_percentile":4639.47,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1252.52,"10th_percentile":1252.52,"90th_percentile":1252.52,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":351.33,"10th_percentile":266.32,"90th_percentile":463.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":213.45,"10th_percentile":202.8,"90th_percentile":311.25,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"47","median_amount":285.85,"10th_percentile":124.88,"90th_percentile":362.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":1943.0,"10th_percentile":1943.0,"90th_percentile":1943.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":850.24,"10th_percentile":850.24,"90th_percentile":850.24,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":382.35,"10th_percentile":330.63,"90th_percentile":1469.21,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":145.2,"10th_percentile":145.2,"90th_percentile":145.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":268.27,"10th_percentile":221.51,"90th_percentile":274.86,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":945.69,"10th_percentile":492.66,"90th_percentile":1616.17},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":215.08,"10th_percentile":204.38,"90th_percentile":278.99,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":357.63,"10th_percentile":266.32,"90th_percentile":473.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"57","median_amount":234.25,"10th_percentile":206.86,"90th_percentile":1515.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":331.66,"10th_percentile":285.85,"90th_percentile":450.87,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":510.47,"10th_percentile":510.47,"90th_percentile":510.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Musculoskeletal Procedures","code_information":[{"code":"5112","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":1465.05,"10th_percentile":596.88,"90th_percentile":2278.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1551.24,"10th_percentile":1287.33,"90th_percentile":6555.02,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2373.58,"10th_percentile":2373.58,"90th_percentile":2373.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1823.06,"10th_percentile":1823.06,"90th_percentile":1823.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"51","median_amount":5205.4,"10th_percentile":3396.09,"90th_percentile":7014.83,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":14231.89,"10th_percentile":14231.89,"90th_percentile":14231.89},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6843.03,"10th_percentile":6843.03,"90th_percentile":6843.03,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":1514.73,"10th_percentile":1183.35,"90th_percentile":1558.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3071.17,"10th_percentile":3071.17,"90th_percentile":3071.17,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":1863.18,"10th_percentile":1727.86,"90th_percentile":3950.65,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"37","median_amount":1453.82,"10th_percentile":1098.47,"90th_percentile":1651.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":11661.06,"10th_percentile":8796.91,"90th_percentile":17064.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":642.93,"10th_percentile":642.93,"90th_percentile":1385.97,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":819.2,"10th_percentile":819.2,"90th_percentile":819.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":520.29,"10th_percentile":274.79,"90th_percentile":1015.78,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":4041.02,"10th_percentile":3529.87,"90th_percentile":4510.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2351.84,"10th_percentile":1767.55,"90th_percentile":4903.54,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":1527.23,"10th_percentile":1242.15,"90th_percentile":1642.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":1569.16,"10th_percentile":1183.93,"90th_percentile":2633.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":1443.05,"10th_percentile":1207.85,"90th_percentile":1898.3,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1661.62,"10th_percentile":1661.62,"90th_percentile":2215.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Musculoskeletal Procedures","code_information":[{"code":"5113","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":16244.69,"10th_percentile":16244.69,"90th_percentile":21796.08},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"31","median_amount":2464.24,"10th_percentile":1027.99,"90th_percentile":4429.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":2951.16,"10th_percentile":2780.68,"90th_percentile":3189.8,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4780.3,"10th_percentile":4780.3,"90th_percentile":4780.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3287.59,"10th_percentile":3287.59,"90th_percentile":3287.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"117","median_amount":5935.85,"10th_percentile":3205.58,"90th_percentile":11241.98,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":2777.32,"10th_percentile":2776.64,"90th_percentile":3092.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1208.86,"10th_percentile":1208.86,"90th_percentile":1208.86,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":3580.99,"10th_percentile":2292.59,"90th_percentile":5464.71,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"64","median_amount":3066.94,"10th_percentile":2593.04,"90th_percentile":6457.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"12","median_amount":14614.19,"10th_percentile":6085.41,"90th_percentile":32501.96},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5978.35,"10th_percentile":5978.35,"90th_percentile":5978.35,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":2886.83,"10th_percentile":2007.29,"90th_percentile":4469.12,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1233.99,"10th_percentile":1233.99,"90th_percentile":1233.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":1276.99,"10th_percentile":1107.28,"90th_percentile":2574.19,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":13939.46,"10th_percentile":9044.82,"90th_percentile":26360.55},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":2508.48,"10th_percentile":1983.88,"90th_percentile":3194.18,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"33","median_amount":2895.82,"10th_percentile":2552.15,"90th_percentile":3190.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"68","median_amount":2958.24,"10th_percentile":1926.53,"90th_percentile":5310.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":2822.17,"10th_percentile":2515.32,"90th_percentile":3144.14,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4491.63,"10th_percentile":2919.56,"90th_percentile":9051.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Musculoskeletal Procedures","code_information":[{"code":"5114","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":62187.24,"10th_percentile":62187.24,"90th_percentile":62187.24},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":5505.77,"10th_percentile":1588.66,"90th_percentile":10143.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6833.02,"10th_percentile":6467.89,"90th_percentile":7114.23,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10565.44,"10th_percentile":10565.44,"90th_percentile":10565.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"59","median_amount":11415.56,"10th_percentile":7438.21,"90th_percentile":21743.1,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":15697.98,"10th_percentile":15697.98,"90th_percentile":15697.98},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9286.43,"10th_percentile":8154.9,"90th_percentile":9376.18,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":6555.02,"10th_percentile":6476.83,"90th_percentile":6931.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":12820.58,"10th_percentile":12820.58,"90th_percentile":12820.58,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":18184.24,"10th_percentile":18184.24,"90th_percentile":18184.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4833.7,"10th_percentile":4100.2,"90th_percentile":10692.88,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"59","median_amount":6677.52,"10th_percentile":6327.01,"90th_percentile":7117.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":14115.95,"10th_percentile":5037.32,"90th_percentile":32594.42},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7486.32,"10th_percentile":7185.29,"90th_percentile":7486.32,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5459.42,"10th_percentile":5122.75,"90th_percentile":6688.55,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1596.89,"10th_percentile":1596.89,"90th_percentile":1609.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1960.62,"10th_percentile":1886.27,"90th_percentile":5527.84,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":28316.41,"10th_percentile":28316.41,"90th_percentile":31621.9},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5803.57,"10th_percentile":5030.96,"90th_percentile":9619.64,"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 ($): FEE SCHEDULE]","count":"27","median_amount":6629.53,"10th_percentile":5538.02,"90th_percentile":7000.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"38","median_amount":5260.67,"10th_percentile":4195.72,"90th_percentile":7863.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":6555.02,"10th_percentile":5632.69,"90th_percentile":6625.83,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9889.32,"10th_percentile":9889.32,"90th_percentile":9889.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 5 Musculoskeletal Procedures","code_information":[{"code":"5115","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":40610.78,"10th_percentile":40189.4,"90th_percentile":49504.83},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"20","median_amount":7574.78,"10th_percentile":2143.68,"90th_percentile":14864.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"48","median_amount":12679.75,"10th_percentile":10411.39,"90th_percentile":13020.92,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":21075.8,"10th_percentile":21075.8,"90th_percentile":21075.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"154","median_amount":27376.79,"10th_percentile":21630.16,"90th_percentile":30299.99,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12984.03,"10th_percentile":12984.03,"90th_percentile":12984.03,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"59","median_amount":12501.79,"10th_percentile":12002.99,"90th_percentile":12985.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":23690.51,"10th_percentile":23690.51,"90th_percentile":23690.51,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":25675.28,"10th_percentile":25675.28,"90th_percentile":25675.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":9350.79,"10th_percentile":7895.14,"90th_percentile":11489.82,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"210","median_amount":12564.36,"10th_percentile":11766.55,"90th_percentile":13023.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":25215.36,"10th_percentile":25215.36,"90th_percentile":25215.36},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":29796.12,"10th_percentile":9304.94,"90th_percentile":53534.43},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8671.0,"10th_percentile":8125.07,"90th_percentile":13868.44,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8790.19,"10th_percentile":8569.26,"90th_percentile":9710.75,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2557.31,"10th_percentile":2109.06,"90th_percentile":3824.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2342.24,"10th_percentile":1784.81,"90th_percentile":4703.44,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"19","median_amount":36576.72,"10th_percentile":20740.01,"90th_percentile":42492.55},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":8877.87,"10th_percentile":8279.33,"90th_percentile":13272.49,"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 ($): FEE SCHEDULE]","count":"133","median_amount":12688.44,"10th_percentile":10353.99,"90th_percentile":13022.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"49","median_amount":8435.95,"10th_percentile":6088.04,"90th_percentile":11002.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":11911.15,"10th_percentile":10359.67,"90th_percentile":12807.71,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"12","median_amount":17941.83,"10th_percentile":17073.7,"90th_percentile":18498.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 6 Musculoskeletal Procedures","code_information":[{"code":"5116","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":14338.1,"10th_percentile":14338.1,"90th_percentile":14338.1,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16987.59,"10th_percentile":16987.59,"90th_percentile":16987.59,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16612.59,"10th_percentile":16612.59,"90th_percentile":18263.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18204.76,"10th_percentile":18204.76,"90th_percentile":18204.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":17991.34,"10th_percentile":17991.34,"90th_percentile":17991.34,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Airway Endoscopy","code_information":[{"code":"5151","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":607.31,"10th_percentile":562.36,"90th_percentile":781.05},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":153.75,"10th_percentile":119.55,"90th_percentile":226.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":250.41,"10th_percentile":188.13,"90th_percentile":313.11,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":511.04,"10th_percentile":511.04,"90th_percentile":511.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":153.75,"10th_percentile":153.75,"90th_percentile":165.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"72","median_amount":379.04,"10th_percentile":284.28,"90th_percentile":418.59,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":217.04,"10th_percentile":213.17,"90th_percentile":230.29,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"59","median_amount":299.44,"10th_percentile":250.4,"90th_percentile":313.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":209.29,"10th_percentile":209.29,"90th_percentile":209.29,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":313.0,"10th_percentile":313.0,"90th_percentile":313.0},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":153.75,"10th_percentile":153.75,"90th_percentile":165.15,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"97","median_amount":288.21,"10th_percentile":124.88,"90th_percentile":316.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":798.44,"10th_percentile":798.44,"90th_percentile":798.45,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":204.59,"10th_percentile":204.59,"90th_percentile":204.59,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":258.3,"10th_percentile":156.82,"90th_percentile":781.05},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":213.17,"10th_percentile":213.17,"90th_percentile":213.17,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":153.75,"10th_percentile":153.75,"90th_percentile":162.6,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":120.2,"10th_percentile":120.2,"90th_percentile":120.2},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":120.2,"10th_percentile":120.2,"90th_percentile":120.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":69.22,"10th_percentile":68.68,"90th_percentile":111.47,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":512.5,"10th_percentile":310.9,"90th_percentile":820.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":153.75,"10th_percentile":153.75,"90th_percentile":174.9,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"85","median_amount":250.4,"10th_percentile":124.89,"90th_percentile":313.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"74","median_amount":156.82,"10th_percentile":148.26,"90th_percentile":165.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"45","median_amount":159.62,"10th_percentile":100.38,"90th_percentile":313.0,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":447.14,"10th_percentile":273.57,"90th_percentile":447.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Airway Endoscopy","code_information":[{"code":"5153","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":14308.48,"10th_percentile":14308.48,"90th_percentile":14308.48},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":6000.62,"10th_percentile":2301.05,"90th_percentile":10959.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2685.12,"10th_percentile":2685.12,"90th_percentile":2685.12,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":3574.79,"10th_percentile":1347.68,"90th_percentile":6492.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4262.92,"10th_percentile":4262.92,"90th_percentile":4262.92,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":3926.82,"10th_percentile":3926.82,"90th_percentile":3926.82},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":637.03,"10th_percentile":637.03,"90th_percentile":637.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":43.05,"10th_percentile":43.05,"90th_percentile":43.05,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1671.08,"10th_percentile":1646.38,"90th_percentile":6735.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5087.43,"10th_percentile":5087.43,"90th_percentile":5087.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3278.79,"10th_percentile":1328.08,"90th_percentile":6340.62,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Airway Endoscopy","code_information":[{"code":"5154","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2402.44,"10th_percentile":1910.32,"90th_percentile":3337.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3387.46,"10th_percentile":2858.23,"90th_percentile":6713.62,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":13147.98,"10th_percentile":6948.14,"90th_percentile":29047.83,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3205.29,"10th_percentile":3118.68,"90th_percentile":3572.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2516.43,"10th_percentile":2516.43,"90th_percentile":2516.43,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":3249.39,"10th_percentile":2989.69,"90th_percentile":6512.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5120.96,"10th_percentile":5120.96,"90th_percentile":5120.96,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2107.08,"10th_percentile":2107.08,"90th_percentile":2107.08,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":482.77,"10th_percentile":482.77,"90th_percentile":482.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":14145.38,"10th_percentile":14145.38,"90th_percentile":14145.38},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3512.68,"10th_percentile":3038.84,"90th_percentile":6735.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2766.35,"10th_percentile":2166.57,"90th_percentile":8863.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3233.64,"10th_percentile":3118.46,"90th_percentile":3572.79,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5103.98,"10th_percentile":5103.98,"90th_percentile":5103.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 5 Airway Endoscopy","code_information":[{"code":"5155","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":7069.48,"10th_percentile":6504.58,"90th_percentile":9735.63,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6804.94,"10th_percentile":6804.94,"90th_percentile":6804.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6802.98,"10th_percentile":6802.98,"90th_percentile":6802.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2621.33,"10th_percentile":2621.33,"90th_percentile":2621.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2530.77,"10th_percentile":2530.77,"90th_percentile":3342.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6194.64,"10th_percentile":6194.64,"90th_percentile":6194.64,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2711.64,"10th_percentile":2410.85,"90th_percentile":3790.61,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 ENT Procedures","code_information":[{"code":"5161","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":11067.31,"10th_percentile":11067.31,"90th_percentile":11067.31},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"36","median_amount":2170.71,"10th_percentile":1644.64,"90th_percentile":2705.85,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3148.15,"10th_percentile":3148.15,"90th_percentile":3148.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2853.7,"10th_percentile":2853.7,"90th_percentile":2853.7,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"39","median_amount":7126.19,"10th_percentile":4246.56,"90th_percentile":9105.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":1658.92,"10th_percentile":1658.92,"90th_percentile":1728.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":229.62,"10th_percentile":229.62,"90th_percentile":229.62,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":2506.53,"10th_percentile":2172.9,"90th_percentile":3027.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1448.53,"10th_percentile":1448.53,"90th_percentile":1448.53,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1658.92,"10th_percentile":1658.92,"90th_percentile":1658.92,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":14120.39,"10th_percentile":14120.39,"90th_percentile":14120.39},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"38","median_amount":1658.92,"10th_percentile":1658.92,"90th_percentile":2407.66,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2060.26,"10th_percentile":2060.26,"90th_percentile":3755.47,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1586.83,"10th_percentile":1363.09,"90th_percentile":1800.91,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":13796.01,"10th_percentile":13796.01,"90th_percentile":13796.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"146","median_amount":2402.85,"10th_percentile":1746.47,"90th_percentile":3018.01,"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":"Wellcare","plan_name":"Medicare 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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 ENT Procedures","code_information":[{"code":"5162","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":502.89,"10th_percentile":502.89,"90th_percentile":502.89,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2201.01,"10th_percentile":2201.01,"90th_percentile":2201.01,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1958.4,"10th_percentile":1958.4,"90th_percentile":1958.4,"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":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1450.87,"10th_percentile":1397.75,"90th_percentile":3468.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1555.15,"10th_percentile":1555.15,"90th_percentile":1555.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 ENT Procedures","code_information":[{"code":"5163","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":6650.89,"10th_percentile":6650.89,"90th_percentile":6650.89},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2343.54,"10th_percentile":2343.54,"90th_percentile":2343.54,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1480.96,"10th_percentile":1480.96,"90th_percentile":1480.96,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"107","median_amount":3457.63,"10th_percentile":1588.62,"90th_percentile":5090.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":6572.92,"10th_percentile":6572.92,"90th_percentile":6572.92},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2819.47,"10th_percentile":2819.47,"90th_percentile":2819.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1441.27,"10th_percentile":1088.32,"90th_percentile":2917.85,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1165.21,"10th_percentile":1165.21,"90th_percentile":1165.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":10295.83,"10th_percentile":10295.83,"90th_percentile":10295.83,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":1417.61,"10th_percentile":1327.16,"90th_percentile":1759.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1435.42,"10th_percentile":1015.02,"90th_percentile":1443.32,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2819.47,"10th_percentile":2819.47,"90th_percentile":2819.47,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":5114.69,"10th_percentile":5114.69,"90th_percentile":5842.64},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":2819.47,"10th_percentile":1958.4,"90th_percentile":2937.6,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":1377.23,"10th_percentile":1327.53,"90th_percentile":1910.81,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":256.9,"10th_percentile":256.9,"90th_percentile":256.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":317.8,"10th_percentile":317.8,"90th_percentile":452.9,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":3661.89,"10th_percentile":1298.18,"90th_percentile":8244.85},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"20","median_amount":1383.62,"10th_percentile":1326.76,"90th_percentile":1851.61,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1414.2,"10th_percentile":1148.34,"90th_percentile":1441.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"128","median_amount":1452.91,"10th_percentile":1346.36,"90th_percentile":1747.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1092.42,"10th_percentile":1085.51,"90th_percentile":1141.42,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":282.99,"10th_percentile":282.99,"90th_percentile":282.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 ENT Procedures","code_information":[{"code":"5164","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":8965.98,"10th_percentile":8965.98,"90th_percentile":8965.98},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1948.94,"10th_percentile":1948.94,"90th_percentile":1948.94,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"53","median_amount":5992.61,"10th_percentile":3130.48,"90th_percentile":8440.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2972.27,"10th_percentile":2972.27,"90th_percentile":4051.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2775.15,"10th_percentile":2775.15,"90th_percentile":3142.65,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3536.89,"10th_percentile":3536.89,"90th_percentile":3536.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1659.86,"10th_percentile":1659.86,"90th_percentile":1659.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3154.55,"10th_percentile":2893.65,"90th_percentile":3519.36,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":5252.27,"10th_percentile":5252.27,"90th_percentile":5252.27},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":7463.24,"10th_percentile":7463.24,"90th_percentile":7463.24},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2972.27,"10th_percentile":2972.27,"90th_percentile":2972.27,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2663.16,"10th_percentile":2022.22,"90th_percentile":4489.08,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":507.29,"10th_percentile":507.29,"90th_percentile":507.29,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":548.22,"10th_percentile":548.22,"90th_percentile":548.22,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":5479.82,"10th_percentile":5479.82,"90th_percentile":5479.82},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1842.61,"10th_percentile":1801.05,"90th_percentile":2519.79,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3152.56,"10th_percentile":3152.56,"90th_percentile":3152.56,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"59","median_amount":2041.6,"10th_percentile":1553.3,"90th_percentile":3032.98,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3142.65,"10th_percentile":3142.65,"90th_percentile":3150.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2244.75,"10th_percentile":2244.75,"90th_percentile":2244.75,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":7536.81,"10th_percentile":6449.47,"90th_percentile":9712.25},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"55","median_amount":1756.98,"10th_percentile":1396.31,"90th_percentile":1866.57,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5737.98,"10th_percentile":5737.98,"90th_percentile":5737.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9359.15,"10th_percentile":9359.15,"90th_percentile":9359.15,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1720.61,"10th_percentile":1720.61,"90th_percentile":1720.61,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"95","median_amount":4807.4,"10th_percentile":3285.25,"90th_percentile":6461.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2972.27,"10th_percentile":2972.27,"90th_percentile":6891.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":1783.77,"10th_percentile":1659.61,"90th_percentile":3112.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5345.38,"10th_percentile":5297.3,"90th_percentile":5741.88,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11216.95,"10th_percentile":11216.95,"90th_percentile":11216.95,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":8624.66,"10th_percentile":3566.93,"90th_percentile":10714.24},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2852.76,"10th_percentile":2852.76,"90th_percentile":2972.27,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":1883.48,"10th_percentile":1703.45,"90th_percentile":1970.43,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":498.64,"10th_percentile":498.64,"90th_percentile":498.64,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":421.36,"10th_percentile":421.36,"90th_percentile":422.62,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":6710.93,"10th_percentile":5978.0,"90th_percentile":8615.53},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":1814.91,"10th_percentile":1768.35,"90th_percentile":4675.73,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5732.49,"10th_percentile":5503.19,"90th_percentile":5737.17,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"145","median_amount":1817.75,"10th_percentile":1692.88,"90th_percentile":1987.23,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5750.33,"10th_percentile":5750.33,"90th_percentile":5750.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8189.26,"10th_percentile":8189.26,"90th_percentile":8189.26,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":574.54,"10th_percentile":565.77,"90th_percentile":5155.92,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":603.37,"10th_percentile":454.49,"90th_percentile":726.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":554.44,"10th_percentile":554.44,"90th_percentile":554.44,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":3526.87,"10th_percentile":1775.43,"90th_percentile":4456.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":568.26,"10th_percentile":379.57,"90th_percentile":684.44,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3697.41,"10th_percentile":3697.41,"90th_percentile":3697.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2889.74,"10th_percentile":557.65,"90th_percentile":3948.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"89","median_amount":599.12,"10th_percentile":172.82,"90th_percentile":1520.33,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":975.6,"10th_percentile":975.6,"90th_percentile":975.6,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":909.45,"10th_percentile":909.45,"90th_percentile":909.45,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":13095.03,"10th_percentile":13095.03,"90th_percentile":13095.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"46","median_amount":599.13,"10th_percentile":381.02,"90th_percentile":1153.01,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":677.48,"10th_percentile":586.03,"90th_percentile":2625.94,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":311.14,"10th_percentile":300.22,"90th_percentile":898.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":855.89,"10th_percentile":855.89,"90th_percentile":855.89,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2423.4,"10th_percentile":2423.4,"90th_percentile":6646.05,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2942.23,"10th_percentile":1510.34,"90th_percentile":3050.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"18","median_amount":4515.79,"10th_percentile":2553.98,"90th_percentile":8832.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1555.82,"10th_percentile":1555.82,"90th_percentile":1555.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":1448.69,"10th_percentile":1137.84,"90th_percentile":6342.96,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":4479.25,"10th_percentile":4479.25,"90th_percentile":4479.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":5721.13,"10th_percentile":5721.13,"90th_percentile":5721.13,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1607.36,"10th_percentile":1607.36,"90th_percentile":1914.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"25","median_amount":1448.69,"10th_percentile":1107.58,"90th_percentile":3050.03,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1511.48,"10th_percentile":1511.48,"90th_percentile":1511.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":139.24,"10th_percentile":139.24,"90th_percentile":139.24,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":2250.77,"10th_percentile":2250.77,"90th_percentile":2250.77},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":751.15,"10th_percentile":751.15,"90th_percentile":751.15,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1454.61,"10th_percentile":1179.2,"90th_percentile":3052.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"20","median_amount":1415.09,"10th_percentile":780.02,"90th_percentile":5230.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1511.34,"10th_percentile":1204.27,"90th_percentile":4540.29,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2150.48,"10th_percentile":2150.48,"90th_percentile":2150.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Vascular Procedures","code_information":[{"code":"5183","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":26345.24,"10th_percentile":26345.24,"90th_percentile":26345.24},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":2329.46,"10th_percentile":1007.6,"90th_percentile":3342.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":2805.03,"10th_percentile":2440.02,"90th_percentile":3153.14,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"50","median_amount":8020.71,"10th_percentile":4484.01,"90th_percentile":16422.0,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":2596.07,"10th_percentile":2596.07,"90th_percentile":2596.07},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2957.8,"10th_percentile":2957.8,"90th_percentile":2957.8,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":2883.3,"10th_percentile":2625.25,"90th_percentile":3057.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":4049.0,"10th_percentile":4049.0,"90th_percentile":4049.0,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4512.81,"10th_percentile":4512.81,"90th_percentile":4512.81,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":2364.86,"10th_percentile":2261.44,"90th_percentile":4848.5,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"88","median_amount":2757.29,"10th_percentile":2466.93,"90th_percentile":3056.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":14128.73,"10th_percentile":9000.0,"90th_percentile":49020.33},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3640.38,"10th_percentile":3640.38,"90th_percentile":3640.38,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2665.59,"10th_percentile":2178.08,"90th_percentile":5622.47,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2775.63,"10th_percentile":2775.63,"90th_percentile":2775.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":461.36,"10th_percentile":461.36,"90th_percentile":461.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":456.99,"10th_percentile":456.99,"90th_percentile":456.99,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":12611.25,"10th_percentile":12083.22,"90th_percentile":14219.38},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2302.29,"10th_percentile":2172.94,"90th_percentile":5864.79,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":2885.66,"10th_percentile":2440.02,"90th_percentile":3057.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"44","median_amount":2597.48,"10th_percentile":2239.33,"90th_percentile":6306.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":2707.03,"10th_percentile":2440.02,"90th_percentile":3050.03,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3732.52,"10th_percentile":3732.52,"90th_percentile":3732.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Vascular Procedures","code_information":[{"code":"5184","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5039.63,"10th_percentile":5039.63,"90th_percentile":5039.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5242.82,"10th_percentile":5242.82,"90th_percentile":5242.82,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":12592.0,"10th_percentile":9739.18,"90th_percentile":27398.66,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4874.66,"10th_percentile":4874.66,"90th_percentile":5076.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3063.63,"10th_percentile":3063.63,"90th_percentile":3905.41,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4974.76,"10th_percentile":4827.49,"90th_percentile":5243.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4980.68,"10th_percentile":4980.68,"90th_percentile":4980.68,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":24474.84,"10th_percentile":24474.84,"90th_percentile":24474.84},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4925.42,"10th_percentile":4925.42,"90th_percentile":10166.85,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5365.29,"10th_percentile":5365.29,"90th_percentile":6476.63,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4194.58,"10th_percentile":4115.87,"90th_percentile":5263.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5354.08,"10th_percentile":3238.45,"90th_percentile":5844.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4974.76,"10th_percentile":4944.31,"90th_percentile":5242.16,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Endovascular Procedures","code_information":[{"code":"5191","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"36","median_amount":4316.32,"10th_percentile":875.52,"90th_percentile":7043.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"46","median_amount":3116.81,"10th_percentile":2798.31,"90th_percentile":5269.78,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3559.05,"10th_percentile":3559.05,"90th_percentile":3559.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"71","median_amount":15312.83,"10th_percentile":11225.03,"90th_percentile":24237.15,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":6303.27,"10th_percentile":2903.96,"90th_percentile":14382.71},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3407.72,"10th_percentile":3407.72,"90th_percentile":4049.7,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"63","median_amount":2960.71,"10th_percentile":2690.79,"90th_percentile":5202.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":11507.28,"10th_percentile":11507.28,"90th_percentile":12095.71,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":5076.69,"10th_percentile":4071.87,"90th_percentile":8880.1,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"176","median_amount":2992.74,"10th_percentile":2651.32,"90th_percentile":4852.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7908.11,"10th_percentile":7908.11,"90th_percentile":7908.11,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":24705.47,"10th_percentile":24705.47,"90th_percentile":24705.47},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":3407.72,"10th_percentile":3270.7,"90th_percentile":4658.46,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4102.27,"10th_percentile":3315.8,"90th_percentile":12403.11,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":489.91,"10th_percentile":489.91,"90th_percentile":489.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2493.45,"10th_percentile":2493.45,"90th_percentile":2493.45,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":540.17,"10th_percentile":449.25,"90th_percentile":1466.81,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":21461.91,"10th_percentile":14957.94,"90th_percentile":54785.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5635.98,"10th_percentile":3731.82,"90th_percentile":10835.44,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"101","median_amount":3116.83,"10th_percentile":2631.99,"90th_percentile":5122.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"52","median_amount":4474.73,"10th_percentile":3657.44,"90th_percentile":9490.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":2830.52,"10th_percentile":2786.94,"90th_percentile":3142.93,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6625.93,"10th_percentile":6625.93,"90th_percentile":7892.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Endovascular Procedures","code_information":[{"code":"5192","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8796.28,"10th_percentile":8796.28,"90th_percentile":8796.28,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":17185.78,"10th_percentile":17185.78,"90th_percentile":17185.78,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5524.98,"10th_percentile":5524.98,"90th_percentile":5580.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"16","median_amount":5335.29,"10th_percentile":4974.21,"90th_percentile":5533.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":11339.1,"10th_percentile":11339.1,"90th_percentile":11339.1},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5423.41,"10th_percentile":5417.18,"90th_percentile":5529.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5524.98,"10th_percentile":4933.27,"90th_percentile":5547.53,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Endovascular Procedures","code_information":[{"code":"5193","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11242.58,"10th_percentile":1297.56,"90th_percentile":17416.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10989.41,"10th_percentile":10989.41,"90th_percentile":11002.53,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"19","median_amount":22226.4,"10th_percentile":2965.83,"90th_percentile":33766.31,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10989.42,"10th_percentile":9964.41,"90th_percentile":11213.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":537.89,"10th_percentile":537.89,"90th_percentile":537.89,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"39","median_amount":10602.32,"10th_percentile":9706.29,"90th_percentile":10998.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13614.79,"10th_percentile":13614.79,"90th_percentile":13614.79,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11313.98,"10th_percentile":11313.98,"90th_percentile":11313.98,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":872.3,"10th_percentile":872.3,"90th_percentile":872.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2133.93,"10th_percentile":2133.93,"90th_percentile":2133.93,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":38909.49,"10th_percentile":38909.49,"90th_percentile":38909.49},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10879.39,"10th_percentile":10879.39,"90th_percentile":10879.39,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":10646.42,"10th_percentile":8791.53,"90th_percentile":11009.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11966.15,"10th_percentile":9182.27,"90th_percentile":13162.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10695.42,"10th_percentile":9681.79,"90th_percentile":12515.02,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Endovascular Procedures","code_information":[{"code":"5194","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":17400.69,"10th_percentile":17400.69,"90th_percentile":17400.69,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":35556.39,"10th_percentile":22114.52,"90th_percentile":49853.61,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":17400.69,"10th_percentile":17400.69,"90th_percentile":17400.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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":"13","median_amount":17205.31,"10th_percentile":16817.59,"90th_percentile":17400.69,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":17866.52,"10th_percentile":17866.52,"90th_percentile":17866.52,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5936.42,"10th_percentile":5936.42,"90th_percentile":5936.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16964.6,"10th_percentile":16405.11,"90th_percentile":17471.72,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16243.48,"10th_percentile":16243.48,"90th_percentile":16250.36,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":17106.69,"10th_percentile":17106.69,"90th_percentile":17106.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Implantation Wireless PA Pressure Monitor","code_information":[{"code":"5200","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":26968.8,"10th_percentile":26968.8,"90th_percentile":26968.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Electrophysiologic Procedures","code_information":[{"code":"5212","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":15228.46,"10th_percentile":15228.46,"90th_percentile":15228.46,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7032.54,"10th_percentile":7032.54,"90th_percentile":7032.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5882.51,"10th_percentile":5882.51,"90th_percentile":5882.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7015.76,"10th_percentile":7015.76,"90th_percentile":7015.76,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Electrophysiologic Procedures","code_information":[{"code":"5213","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":123812.8,"10th_percentile":123812.8,"90th_percentile":123812.8},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"17","median_amount":50003.31,"10th_percentile":34213.24,"90th_percentile":54089.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":23405.16,"10th_percentile":21214.35,"90th_percentile":23772.67,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":50132.7,"10th_percentile":50132.7,"90th_percentile":50132.7,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15830.85,"10th_percentile":15830.85,"90th_percentile":15830.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":23772.96,"10th_percentile":21502.01,"90th_percentile":23780.07,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":22488.22,"10th_percentile":22488.22,"90th_percentile":23419.11,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":115738.2,"10th_percentile":115738.2,"90th_percentile":115738.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":23384.89,"10th_percentile":21487.36,"90th_percentile":23790.98,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":19028.26,"10th_percentile":12146.55,"90th_percentile":25013.62,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":23478.66,"10th_percentile":23429.66,"90th_percentile":23778.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":33738.6,"10th_percentile":33738.6,"90th_percentile":33738.6,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5102.82,"10th_percentile":5102.82,"90th_percentile":5102.82,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":13.12,"10th_percentile":13.12,"90th_percentile":13.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":16136.17,"10th_percentile":52.33,"90th_percentile":39292.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7690.42,"10th_percentile":7395.82,"90th_percentile":8052.45,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":24968.91,"10th_percentile":24968.91,"90th_percentile":24968.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11370.55,"10th_percentile":11370.55,"90th_percentile":11370.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":7925.03,"10th_percentile":7627.71,"90th_percentile":8026.32,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":25115.87,"10th_percentile":25115.87,"90th_percentile":25115.87},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10895.13,"10th_percentile":10895.13,"90th_percentile":10895.13,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":11478.0,"10th_percentile":11478.0,"90th_percentile":11478.0,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":821.37,"10th_percentile":821.37,"90th_percentile":821.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":12921.38,"10th_percentile":12921.38,"90th_percentile":12921.38},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7691.42,"10th_percentile":7384.0,"90th_percentile":8052.45,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5276.11,"10th_percentile":5273.21,"90th_percentile":5276.19,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6415.77,"10th_percentile":6415.77,"90th_percentile":6415.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9920.78,"10th_percentile":8113.02,"90th_percentile":10141.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":42847.6,"10th_percentile":24854.05,"90th_percentile":46101.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":54142.64,"10th_percentile":54142.64,"90th_percentile":54142.64},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10457.03,"10th_percentile":10457.03,"90th_percentile":10457.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":10111.67,"10th_percentile":9414.72,"90th_percentile":10148.78,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":39122.51,"10th_percentile":39122.51,"90th_percentile":39122.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":24997.97,"10th_percentile":24997.97,"90th_percentile":24997.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":10043.28,"10th_percentile":9372.04,"90th_percentile":18377.72,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":39755.3,"10th_percentile":39755.3,"90th_percentile":39755.3},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"27","median_amount":9957.82,"10th_percentile":8113.02,"90th_percentile":10149.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12983.91,"10th_percentile":8418.34,"90th_percentile":19055.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9798.28,"10th_percentile":9773.77,"90th_percentile":10055.03,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Pacemaker and Similar Procedures","code_information":[{"code":"5224","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8368.96,"10th_percentile":8368.96,"90th_percentile":8368.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":17625.7,"10th_percentile":17625.7,"90th_percentile":17625.7,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":66249.91,"10th_percentile":66249.91,"90th_percentile":66249.91,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18480.62,"10th_percentile":17766.04,"90th_percentile":18488.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"12","median_amount":18480.62,"10th_percentile":17629.7,"90th_percentile":18487.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":97437.29,"10th_percentile":97437.29,"90th_percentile":97437.29},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18149.67,"10th_percentile":17953.22,"90th_percentile":18494.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 ICD and Similar Procedures","code_information":[{"code":"5231","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":21481.65,"10th_percentile":21481.65,"90th_percentile":21481.65,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":69898.69,"10th_percentile":69898.69,"90th_percentile":100967.52,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":21004.54,"10th_percentile":21004.54,"90th_percentile":21004.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":21658.05,"10th_percentile":21658.05,"90th_percentile":21658.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":29605.54,"10th_percentile":29605.54,"90th_percentile":29605.54,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":21757.05,"10th_percentile":21753.55,"90th_percentile":21839.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":21483.65,"10th_percentile":21483.65,"90th_percentile":21483.65,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 ICD and Similar Procedures","code_information":[{"code":"5232","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":51813.89,"10th_percentile":51813.89,"90th_percentile":51813.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":31068.79,"10th_percentile":31068.79,"90th_percentile":31068.79,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":90241.56,"10th_percentile":88799.37,"90th_percentile":132268.96,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":31068.8,"10th_percentile":29825.32,"90th_percentile":31203.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"16","median_amount":30965.9,"10th_percentile":29367.46,"90th_percentile":32392.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":30779.71,"10th_percentile":29759.47,"90th_percentile":31160.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":38917.73,"10th_percentile":38917.73,"90th_percentile":38917.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":30663.72,"10th_percentile":30663.72,"90th_percentile":31068.8,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Blood Product Exchange and Related Services","code_information":[{"code":"5241","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":5777.81,"10th_percentile":5777.81,"90th_percentile":5777.81},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":3097.83,"10th_percentile":1200.75,"90th_percentile":20063.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1214.0,"10th_percentile":614.66,"90th_percentile":32593.23,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3616.27,"10th_percentile":3616.27,"90th_percentile":3616.27,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":708.83,"10th_percentile":708.83,"90th_percentile":1449.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"49","median_amount":943.71,"10th_percentile":636.64,"90th_percentile":2728.39,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":12008.4,"10th_percentile":12008.4,"90th_percentile":12008.4},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":903.58,"10th_percentile":903.58,"90th_percentile":903.58,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":3640.96,"10th_percentile":3640.96,"90th_percentile":3640.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":642.57,"10th_percentile":642.57,"90th_percentile":1873.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":1255.85,"10th_percentile":736.75,"90th_percentile":2730.8,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":937.3,"10th_percentile":562.66,"90th_percentile":3340.81,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":747.55,"10th_percentile":542.31,"90th_percentile":15530.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"15","median_amount":7566.09,"10th_percentile":4915.8,"90th_percentile":23768.62},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1900.53,"10th_percentile":1090.3,"90th_percentile":4417.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"474","median_amount":3345.46,"10th_percentile":2061.68,"90th_percentile":5476.1,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":2138.81,"10th_percentile":1805.58,"90th_percentile":3876.71},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1383.32,"10th_percentile":1319.34,"90th_percentile":1640.91,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"191","median_amount":1020.7,"10th_percentile":541.03,"90th_percentile":2080.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"15","median_amount":2447.94,"10th_percentile":1190.38,"90th_percentile":5174.97,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3692.81,"10th_percentile":3692.81,"90th_percentile":3692.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1829.85,"10th_percentile":1829.85,"90th_percentile":1829.85,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"62","median_amount":1222.79,"10th_percentile":925.33,"90th_percentile":2164.5,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"421","median_amount":912.24,"10th_percentile":477.33,"90th_percentile":1976.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2282.61,"10th_percentile":2282.61,"90th_percentile":2282.61,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":5129.47,"10th_percentile":5129.47,"90th_percentile":5129.47},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1327.69,"10th_percentile":1327.69,"90th_percentile":1327.69,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"14","median_amount":5497.36,"10th_percentile":1589.96,"90th_percentile":10674.69},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":1383.32,"10th_percentile":1319.34,"90th_percentile":3564.41,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"71","median_amount":1063.49,"10th_percentile":648.43,"90th_percentile":3129.49,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2280.85,"10th_percentile":2280.85,"90th_percentile":2280.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2738.54,"10th_percentile":2738.54,"90th_percentile":2738.54,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":536.92,"10th_percentile":284.11,"90th_percentile":1516.59,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"39","median_amount":3439.52,"10th_percentile":2284.77,"90th_percentile":8427.28},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"62","median_amount":1374.62,"10th_percentile":906.09,"90th_percentile":3194.49,"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 ($): FEE SCHEDULE]","count":"270","median_amount":914.03,"10th_percentile":635.98,"90th_percentile":2220.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"292","median_amount":1336.23,"10th_percentile":945.09,"90th_percentile":2602.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"123","median_amount":912.24,"10th_percentile":614.53,"90th_percentile":1683.6,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"30","median_amount":1243.34,"10th_percentile":778.74,"90th_percentile":2147.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Upper GI Procedures","code_information":[{"code":"5302","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":13445.04,"10th_percentile":13445.04,"90th_percentile":13445.04},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1129.78,"10th_percentile":964.71,"90th_percentile":2503.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":1730.44,"10th_percentile":1519.74,"90th_percentile":2721.72,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"43","median_amount":4621.31,"10th_percentile":2789.75,"90th_percentile":11448.11,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":6629.82,"10th_percentile":6629.82,"90th_percentile":6629.82},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3558.96,"10th_percentile":3558.96,"90th_percentile":3558.96,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1470.75,"10th_percentile":1436.23,"90th_percentile":6116.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1327.89,"10th_percentile":1327.89,"90th_percentile":2233.67,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":1840.45,"10th_percentile":1367.85,"90th_percentile":3686.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":9940.96,"10th_percentile":9940.96,"90th_percentile":10000.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2052.15,"10th_percentile":1327.03,"90th_percentile":7634.26,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":8083.1,"10th_percentile":8083.1,"90th_percentile":8083.1},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2563.93,"10th_percentile":2563.93,"90th_percentile":2563.93,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"34","median_amount":1838.26,"10th_percentile":1470.61,"90th_percentile":2000.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":2058.66,"10th_percentile":1098.42,"90th_percentile":3372.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":1581.85,"10th_percentile":1401.53,"90th_percentile":1838.25,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2626.08,"10th_percentile":2626.08,"90th_percentile":2626.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Upper GI Procedures","code_information":[{"code":"5303","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3441.72,"10th_percentile":3441.72,"90th_percentile":3441.72,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":7439.28,"10th_percentile":7439.28,"90th_percentile":7439.28,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6217.48,"10th_percentile":6217.48,"90th_percentile":6217.48,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3347.72,"10th_percentile":1732.14,"90th_percentile":3624.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3778.82,"10th_percentile":3778.82,"90th_percentile":8890.96,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4786.27,"10th_percentile":3426.28,"90th_percentile":9626.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3382.84,"10th_percentile":3382.84,"90th_percentile":3382.84,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10031.3,"10th_percentile":10031.3,"90th_percentile":10031.3,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2114.62,"10th_percentile":2114.62,"90th_percentile":2114.62,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":17778.04,"10th_percentile":17778.04,"90th_percentile":17778.04},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3796.82,"10th_percentile":3796.82,"90th_percentile":5955.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2762.02,"10th_percentile":2397.08,"90th_percentile":3301.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Lower GI Procedures","code_information":[{"code":"5311","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":6121.98,"10th_percentile":5933.24,"90th_percentile":7548.15},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"49","median_amount":1169.39,"10th_percentile":576.52,"90th_percentile":1526.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"47","median_amount":883.48,"10th_percentile":883.48,"90th_percentile":1350.26,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1442.42,"10th_percentile":1442.42,"90th_percentile":1442.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1143.44,"10th_percentile":1143.44,"90th_percentile":1685.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"315","median_amount":3888.14,"10th_percentile":2607.6,"90th_percentile":5128.38,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":3818.45,"10th_percentile":3666.77,"90th_percentile":4196.44},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1374.62,"10th_percentile":1319.34,"90th_percentile":1374.62,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"67","median_amount":883.48,"10th_percentile":826.74,"90th_percentile":982.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":2205.07,"10th_percentile":1691.58,"90th_percentile":3843.38,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3248.32,"10th_percentile":3248.32,"90th_percentile":3248.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"39","median_amount":1281.91,"10th_percentile":1052.01,"90th_percentile":1621.66,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"187","median_amount":883.48,"10th_percentile":826.74,"90th_percentile":968.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":4688.08,"10th_percentile":4688.08,"90th_percentile":4688.08},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1319.34,"10th_percentile":1319.34,"90th_percentile":1319.34,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"20","median_amount":6533.82,"10th_percentile":1262.11,"90th_percentile":8002.88},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1374.62,"10th_percentile":1215.69,"90th_percentile":2893.8,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":1380.6,"10th_percentile":1066.32,"90th_percentile":1727.14,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":883.48,"10th_percentile":883.48,"90th_percentile":883.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3288.0,"10th_percentile":3288.0,"90th_percentile":3288.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":246.06,"10th_percentile":197.27,"90th_percentile":465.15,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"24","median_amount":6225.49,"10th_percentile":4123.05,"90th_percentile":8042.08},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"26","median_amount":1374.62,"10th_percentile":1144.48,"90th_percentile":2690.25,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"86","median_amount":883.48,"10th_percentile":866.89,"90th_percentile":1353.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"95","median_amount":1340.96,"10th_percentile":1077.3,"90th_percentile":1716.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"40","median_amount":883.48,"10th_percentile":883.48,"90th_percentile":1072.78,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"11","median_amount":1262.11,"10th_percentile":679.64,"90th_percentile":1263.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Lower GI Procedures","code_information":[{"code":"5312","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":8219.75,"10th_percentile":6614.99,"90th_percentile":10400.87},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"37","median_amount":1421.34,"10th_percentile":1149.1,"90th_percentile":2276.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"51","median_amount":1146.42,"10th_percentile":1142.57,"90th_percentile":2051.11,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2412.16,"10th_percentile":2412.16,"90th_percentile":2412.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1191.98,"10th_percentile":1191.98,"90th_percentile":1450.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"255","median_amount":4458.54,"10th_percentile":3039.33,"90th_percentile":6221.36,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":4188.4,"10th_percentile":1714.54,"90th_percentile":5247.18},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1319.34,"10th_percentile":1319.34,"90th_percentile":1319.34,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"65","median_amount":1144.26,"10th_percentile":1071.81,"90th_percentile":1721.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":2353.94,"10th_percentile":493.82,"90th_percentile":3440.28,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":4467.2,"10th_percentile":4467.2,"90th_percentile":4467.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"37","median_amount":1460.1,"10th_percentile":1233.11,"90th_percentile":2048.98,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"173","median_amount":1142.56,"10th_percentile":1067.46,"90th_percentile":1713.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1632.23,"10th_percentile":1632.23,"90th_percentile":3768.86,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1319.34,"10th_percentile":1319.34,"90th_percentile":1319.34,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":8273.6,"10th_percentile":1721.01,"90th_percentile":44224.29},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1374.62,"10th_percentile":1374.62,"90th_percentile":3504.85,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":2318.11,"10th_percentile":1490.76,"90th_percentile":3171.54,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":2281.19,"10th_percentile":2281.19,"90th_percentile":2281.19},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":653.22,"10th_percentile":653.22,"90th_percentile":653.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":726.57,"10th_percentile":726.57,"90th_percentile":1429.79,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"22","median_amount":7387.39,"10th_percentile":4767.31,"90th_percentile":8894.58},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":1569.41,"10th_percentile":1277.92,"90th_percentile":2029.79,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"99","median_amount":1143.5,"10th_percentile":1121.12,"90th_percentile":2038.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"121","median_amount":1662.3,"10th_percentile":1333.94,"90th_percentile":2399.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"43","median_amount":1146.41,"10th_percentile":1142.56,"90th_percentile":1874.11,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"14","median_amount":1632.23,"10th_percentile":1524.94,"90th_percentile":2281.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Lower GI Procedures","code_information":[{"code":"5313","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2125.98,"10th_percentile":2125.98,"90th_percentile":2125.98,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":7296.0,"10th_percentile":4883.41,"90th_percentile":11301.95,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2950.79,"10th_percentile":2950.79,"90th_percentile":2950.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2387.98,"10th_percentile":2387.98,"90th_percentile":2387.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":11041.89,"10th_percentile":11041.89,"90th_percentile":11041.89},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":6046.53,"10th_percentile":6046.53,"90th_percentile":6046.53},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":938.32,"10th_percentile":938.32,"90th_percentile":938.32,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2539.84,"10th_percentile":2518.38,"90th_percentile":2657.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2196.51,"10th_percentile":2196.51,"90th_percentile":4609.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2363.48,"10th_percentile":2363.48,"90th_percentile":2363.48,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complex GI Procedures","code_information":[{"code":"5331","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7091.82,"10th_percentile":7091.82,"90th_percentile":7091.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5773.99,"10th_percentile":5773.99,"90th_percentile":5773.99,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":11526.76,"10th_percentile":11526.76,"90th_percentile":27766.51,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":10668.37,"10th_percentile":10668.37,"90th_percentile":10668.37},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5775.99,"10th_percentile":5775.99,"90th_percentile":5775.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5163.15,"10th_percentile":5163.15,"90th_percentile":5163.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3964.86,"10th_percentile":3964.86,"90th_percentile":3964.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Abdominal/Peritoneal/Biliary and Related Procedures","code_information":[{"code":"5341","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":17489.73,"10th_percentile":17489.73,"90th_percentile":17489.73},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3397.41,"10th_percentile":1671.29,"90th_percentile":4168.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3280.29,"10th_percentile":3280.29,"90th_percentile":3280.29,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5935.2,"10th_percentile":5935.2,"90th_percentile":5935.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4364.96,"10th_percentile":4364.96,"90th_percentile":4364.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"17","median_amount":11869.69,"10th_percentile":4099.84,"90th_percentile":17832.16,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5041.1,"10th_percentile":5041.1,"90th_percentile":5041.1,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3426.68,"10th_percentile":3369.25,"90th_percentile":3643.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":8116.54,"10th_percentile":8116.54,"90th_percentile":8116.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3746.02,"10th_percentile":3213.02,"90th_percentile":3906.48,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":3425.28,"10th_percentile":3116.98,"90th_percentile":3727.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":17761.31,"10th_percentile":17761.31,"90th_percentile":17761.31},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2608.66,"10th_percentile":2608.66,"90th_percentile":2608.66,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5275.19,"10th_percentile":5275.19,"90th_percentile":5275.19,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":743.51,"10th_percentile":743.51,"90th_percentile":743.51,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3340.56,"10th_percentile":3340.56,"90th_percentile":3340.56,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":3419.78,"10th_percentile":3077.46,"90th_percentile":3643.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4616.15,"10th_percentile":1881.28,"90th_percentile":7817.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3419.78,"10th_percentile":2735.83,"90th_percentile":3736.12,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2973.4,"10th_percentile":2973.4,"90th_percentile":2973.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Abdominal/Peritoneal/Biliary and Related Procedures","code_information":[{"code":"5342","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":20005.78,"10th_percentile":20005.78,"90th_percentile":20005.78},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5197.88,"10th_percentile":5197.88,"90th_percentile":5197.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5988.98,"10th_percentile":5988.98,"90th_percentile":5988.98,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"13","median_amount":16155.0,"10th_percentile":10429.51,"90th_percentile":22452.92,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7175.02,"10th_percentile":4541.46,"90th_percentile":10495.52,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5763.94,"10th_percentile":5723.13,"90th_percentile":6053.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":23780.26,"10th_percentile":23780.26,"90th_percentile":23780.26},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4086.29,"10th_percentile":4086.29,"90th_percentile":4494.86,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":18146.63,"10th_percentile":18146.63,"90th_percentile":18146.63},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":7543.24,"10th_percentile":7543.24,"90th_percentile":7543.24,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6052.44,"10th_percentile":6052.44,"90th_percentile":6052.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5258.29,"10th_percentile":4877.09,"90th_percentile":5733.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6082.55,"10th_percentile":6082.55,"90th_percentile":6082.55,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":952.89,"10th_percentile":952.89,"90th_percentile":952.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Laparoscopy and Related Services","code_information":[{"code":"5361","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":18689.64,"10th_percentile":15364.87,"90th_percentile":36803.57},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"95","median_amount":4261.93,"10th_percentile":1982.85,"90th_percentile":6654.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5224.84,"10th_percentile":4522.95,"90th_percentile":5750.03,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9230.53,"10th_percentile":8980.53,"90th_percentile":9232.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3988.55,"10th_percentile":3988.55,"90th_percentile":5433.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"244","median_amount":13183.07,"10th_percentile":8361.11,"90th_percentile":20988.98,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":7040.03,"10th_percentile":7040.03,"90th_percentile":7040.03},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5006.47,"10th_percentile":5006.47,"90th_percentile":15821.84,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"35","median_amount":5286.2,"10th_percentile":5024.68,"90th_percentile":5750.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3815.5,"10th_percentile":3815.5,"90th_percentile":4641.29,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":8907.16,"10th_percentile":8907.16,"90th_percentile":11454.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4914.89,"10th_percentile":4914.89,"90th_percentile":4914.89,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"32","median_amount":4166.97,"10th_percentile":3054.72,"90th_percentile":6388.08,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":5612.3,"10th_percentile":5181.52,"90th_percentile":5751.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":14491.09,"10th_percentile":14491.09,"90th_percentile":14491.09,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":13791.55,"10th_percentile":13791.55,"90th_percentile":13791.55},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"13","median_amount":14979.81,"10th_percentile":6421.32,"90th_percentile":32758.59},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":5778.01,"10th_percentile":4805.15,"90th_percentile":8656.07,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":3805.6,"10th_percentile":3184.45,"90th_percentile":5532.4,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":925.99,"10th_percentile":925.99,"90th_percentile":925.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":2416.04,"10th_percentile":1135.47,"90th_percentile":2969.05,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"18","median_amount":13860.96,"10th_percentile":8377.14,"90th_percentile":29446.02},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"25","median_amount":3970.86,"10th_percentile":3501.92,"90th_percentile":6526.62,"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 ($): FEE SCHEDULE]","count":"31","median_amount":5532.18,"10th_percentile":4522.95,"90th_percentile":5659.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"164","median_amount":4478.27,"10th_percentile":3009.26,"90th_percentile":7086.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":5310.7,"10th_percentile":5219.34,"90th_percentile":5661.2,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"13","median_amount":8076.71,"10th_percentile":6561.37,"90th_percentile":8213.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Laparoscopy and Related Services","code_information":[{"code":"5362","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":6083.87,"10th_percentile":2789.43,"90th_percentile":9526.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10188.55,"10th_percentile":9843.84,"90th_percentile":10190.04,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16625.38,"10th_percentile":16625.38,"90th_percentile":16625.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6186.58,"10th_percentile":6186.58,"90th_percentile":6186.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"74","median_amount":18082.35,"10th_percentile":12739.35,"90th_percentile":24277.05,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9810.67,"10th_percentile":9041.86,"90th_percentile":10190.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":9857.29,"10th_percentile":9857.29,"90th_percentile":9857.29,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":29753.13,"10th_percentile":29753.13,"90th_percentile":29753.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8033.59,"10th_percentile":6711.65,"90th_percentile":10893.42,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":9657.65,"10th_percentile":9311.36,"90th_percentile":10184.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":22645.9,"10th_percentile":22645.9,"90th_percentile":22645.9,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":25573.2,"10th_percentile":25573.2,"90th_percentile":25573.2},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":37647.66,"10th_percentile":37647.66,"90th_percentile":37647.66},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8058.47,"10th_percentile":7806.84,"90th_percentile":10132.02,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6252.85,"10th_percentile":6014.49,"90th_percentile":6353.99,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2236.46,"10th_percentile":2236.46,"90th_percentile":2236.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":821.2,"10th_percentile":531.82,"90th_percentile":3641.88,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":20601.95,"10th_percentile":20601.95,"90th_percentile":20601.95},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8024.7,"10th_percentile":8024.7,"90th_percentile":8442.33,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9746.53,"10th_percentile":7869.59,"90th_percentile":10192.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":6697.19,"10th_percentile":5715.39,"90th_percentile":8559.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9721.35,"10th_percentile":9317.36,"90th_percentile":10478.73,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":14414.34,"10th_percentile":14414.34,"90th_percentile":14414.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Urology and Related Services","code_information":[{"code":"5371","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":343.14,"10th_percentile":235.68,"90th_percentile":361.16,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"23","median_amount":565.5,"10th_percentile":193.53,"90th_percentile":966.36,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":236.38,"10th_percentile":201.38,"90th_percentile":283.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":472.09,"10th_percentile":472.09,"90th_percentile":472.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":365.37,"10th_percentile":365.37,"90th_percentile":365.37},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":153.6,"10th_percentile":153.6,"90th_percentile":2154.0,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"33","median_amount":237.68,"10th_percentile":124.88,"90th_percentile":3404.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":1056.06,"10th_percentile":1056.06,"90th_percentile":1056.06},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":115.45,"10th_percentile":115.45,"90th_percentile":115.45,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":334.97,"10th_percentile":334.97,"90th_percentile":334.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":216.2,"10th_percentile":216.2,"90th_percentile":216.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":31.24,"10th_percentile":31.24,"90th_percentile":50.74,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":891.2,"10th_percentile":891.2,"90th_percentile":1155.5},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2427.69,"10th_percentile":2427.69,"90th_percentile":2427.69,"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 ($): FEE SCHEDULE]","count":"26","median_amount":236.64,"10th_percentile":188.54,"90th_percentile":360.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"30","median_amount":200.28,"10th_percentile":170.44,"90th_percentile":262.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":178.85,"10th_percentile":40.0,"90th_percentile":288.44,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":515.09,"10th_percentile":515.09,"90th_percentile":515.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Urology and Related Services","code_information":[{"code":"5372","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":2435.35,"10th_percentile":2435.35,"90th_percentile":2435.35},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"32","median_amount":479.4,"10th_percentile":216.2,"90th_percentile":2258.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"64","median_amount":646.8,"10th_percentile":517.44,"90th_percentile":659.92,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1008.85,"10th_percentile":1008.85,"90th_percentile":1008.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1247.14,"10th_percentile":1247.14,"90th_percentile":1247.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"114","median_amount":1519.75,"10th_percentile":1139.81,"90th_percentile":4175.11,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":1579.22,"10th_percentile":1579.22,"90th_percentile":1579.22},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2464.41,"10th_percentile":2464.41,"90th_percentile":2464.41,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"79","median_amount":635.36,"10th_percentile":583.62,"90th_percentile":648.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1291.9,"10th_percentile":1291.9,"90th_percentile":1291.9,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3138.69,"10th_percentile":3138.69,"90th_percentile":3138.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":491.81,"10th_percentile":491.81,"90th_percentile":491.81,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":533.1,"10th_percentile":486.9,"90th_percentile":1496.05,"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 ($): FEE SCHEDULE]","count":"206","median_amount":635.32,"10th_percentile":181.3,"90th_percentile":657.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1650.0,"10th_percentile":1650.0,"90th_percentile":1650.0,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1777.0,"10th_percentile":1777.0,"90th_percentile":4618.93},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3982.44,"10th_percentile":3982.44,"90th_percentile":3982.44,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":2663.1,"10th_percentile":2473.45,"90th_percentile":2985.3},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2164.45,"10th_percentile":2164.45,"90th_percentile":4149.29,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1109.23,"10th_percentile":486.9,"90th_percentile":1326.15,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":649.44,"10th_percentile":649.44,"90th_percentile":649.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":526.57,"10th_percentile":526.57,"90th_percentile":526.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":57.84,"10th_percentile":57.83,"90th_percentile":82.83,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":1956.46,"10th_percentile":1893.76,"90th_percentile":2367.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":514.38,"10th_percentile":443.85,"90th_percentile":2319.12,"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":"[APC ($): FEE SCHEDULE]","count":"132","median_amount":582.12,"10th_percentile":318.61,"90th_percentile":649.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"89","median_amount":496.64,"10th_percentile":452.73,"90th_percentile":1429.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"40","median_amount":494.33,"10th_percentile":279.3,"90th_percentile":654.3,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"11","median_amount":772.4,"10th_percentile":53.36,"90th_percentile":924.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Urology and Related Services","code_information":[{"code":"5373","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":4724.44,"10th_percentile":4417.77,"90th_percentile":5042.92},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1423.94,"10th_percentile":1006.5,"90th_percentile":3802.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":1842.43,"10th_percentile":1666.58,"90th_percentile":1985.57,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3008.06,"10th_percentile":3008.06,"90th_percentile":3008.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1288.51,"10th_percentile":1288.51,"90th_percentile":1288.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"129","median_amount":2904.28,"10th_percentile":1028.5,"90th_percentile":5256.92,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2077.42,"10th_percentile":2077.42,"90th_percentile":2077.42,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":1950.78,"10th_percentile":1580.29,"90th_percentile":1985.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1723.13,"10th_percentile":1723.13,"90th_percentile":1723.13,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":7288.36,"10th_percentile":7288.36,"90th_percentile":7288.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":1779.32,"10th_percentile":1095.9,"90th_percentile":2947.16,"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 ($): FEE SCHEDULE]","count":"111","median_amount":1905.68,"10th_percentile":1524.48,"90th_percentile":1993.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2815.34,"10th_percentile":2815.34,"90th_percentile":3802.42,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":6522.3,"10th_percentile":6522.3,"90th_percentile":6522.3},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3961.72,"10th_percentile":2608.66,"90th_percentile":4149.29,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1304.72,"10th_percentile":1245.75,"90th_percentile":1651.18,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1993.18,"10th_percentile":1993.18,"90th_percentile":1993.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":304.0,"10th_percentile":304.0,"90th_percentile":959.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":387.19,"10th_percentile":181.18,"90th_percentile":1085.65,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"13","median_amount":4638.08,"10th_percentile":3355.0,"90th_percentile":6884.95},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1933.6,"10th_percentile":1933.6,"90th_percentile":1933.6,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"61","median_amount":1985.08,"10th_percentile":1588.07,"90th_percentile":1993.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"52","median_amount":1545.98,"10th_percentile":1026.63,"90th_percentile":2628.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":1642.08,"10th_percentile":1588.06,"90th_percentile":1985.08,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2835.83,"10th_percentile":1417.91,"90th_percentile":2835.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Urology and Related Services","code_information":[{"code":"5374","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":9940.75,"10th_percentile":6942.54,"90th_percentile":50221.26},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":2077.42,"10th_percentile":714.84,"90th_percentile":4202.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":3062.88,"10th_percentile":2673.74,"90th_percentile":4926.21,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1805.62,"10th_percentile":1805.62,"90th_percentile":1805.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"50","median_amount":5300.06,"10th_percentile":3159.07,"90th_percentile":13920.04,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":5254.15,"10th_percentile":5254.15,"90th_percentile":5254.15},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"37","median_amount":3158.96,"10th_percentile":2974.67,"90th_percentile":3349.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1582.25,"10th_percentile":1382.64,"90th_percentile":3636.93,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"55","median_amount":3242.73,"10th_percentile":2766.36,"90th_percentile":3351.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":16298.85,"10th_percentile":16298.85,"90th_percentile":16298.85},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2077.42,"10th_percentile":2077.42,"90th_percentile":2077.42,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":21789.84,"10th_percentile":21789.84,"90th_percentile":21789.84},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2164.45,"10th_percentile":2164.45,"90th_percentile":2164.45,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1426.29,"10th_percentile":1426.29,"90th_percentile":1426.29,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3067.77,"10th_percentile":3067.77,"90th_percentile":3067.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":395.14,"10th_percentile":395.14,"90th_percentile":395.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2673.73,"10th_percentile":2673.73,"90th_percentile":2673.73,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1401.69,"10th_percentile":787.4,"90th_percentile":2532.99,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":7319.81,"10th_percentile":4452.92,"90th_percentile":10495.03},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":1972.19,"10th_percentile":1366.33,"90th_percentile":3602.64,"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 ($): FEE SCHEDULE]","count":"37","median_amount":3159.9,"10th_percentile":2673.73,"90th_percentile":3349.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"47","median_amount":1960.7,"10th_percentile":1373.97,"90th_percentile":3617.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":2974.67,"10th_percentile":2673.73,"90th_percentile":3349.17,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3107.33,"10th_percentile":3107.33,"90th_percentile":4775.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 5 Urology and Related Services","code_information":[{"code":"5375","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":7453.49,"10th_percentile":7453.49,"90th_percentile":9344.78},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":1719.11,"10th_percentile":608.85,"90th_percentile":3619.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":4680.55,"10th_percentile":3940.96,"90th_percentile":4926.21,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8042.78,"10th_percentile":8042.78,"90th_percentile":8042.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"101","median_amount":6446.3,"10th_percentile":4125.93,"90th_percentile":11051.7,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":7878.89,"10th_percentile":7878.89,"90th_percentile":7878.89},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5769.7,"10th_percentile":5769.7,"90th_percentile":5769.7,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"37","median_amount":4648.03,"10th_percentile":4432.23,"90th_percentile":7456.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3421.16,"10th_percentile":3421.16,"90th_percentile":3421.16,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4550.4,"10th_percentile":4550.4,"90th_percentile":4550.4,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":2299.58,"10th_percentile":1565.97,"90th_percentile":5153.02,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"59","median_amount":4867.74,"10th_percentile":4460.71,"90th_percentile":7103.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10184.79,"10th_percentile":10184.79,"90th_percentile":10184.79,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":6570.99,"10th_percentile":5318.83,"90th_percentile":11603.07},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3869.46,"10th_percentile":3869.46,"90th_percentile":3869.46,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":8749.8,"10th_percentile":8564.05,"90th_percentile":13736.01},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3876.76,"10th_percentile":3876.76,"90th_percentile":4031.58,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1929.27,"10th_percentile":1579.52,"90th_percentile":3485.74,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":737.93,"10th_percentile":579.43,"90th_percentile":1822.62,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":4284.39,"10th_percentile":4284.39,"90th_percentile":4284.39},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"15","median_amount":6603.37,"10th_percentile":4761.81,"90th_percentile":20218.52},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2431.06,"10th_percentile":1696.14,"90th_percentile":6653.78,"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 ($): FEE SCHEDULE]","count":"47","median_amount":4583.21,"10th_percentile":3940.96,"90th_percentile":4932.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"56","median_amount":1957.89,"10th_percentile":1541.26,"90th_percentile":3585.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4562.56,"10th_percentile":4558.71,"90th_percentile":6677.06,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11558.11,"10th_percentile":8246.13,"90th_percentile":11821.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 6 Urology and Related Services","code_information":[{"code":"5376","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":18009.98,"10th_percentile":9494.56,"90th_percentile":21095.29,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9216.7,"10th_percentile":9216.7,"90th_percentile":9216.7,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8593.32,"10th_percentile":8425.02,"90th_percentile":8911.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8960.82,"10th_percentile":8338.17,"90th_percentile":8966.72,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7168.65,"10th_percentile":7168.65,"90th_percentile":7202.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 7 Urology and Related Services","code_information":[{"code":"5377","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":12590.11,"10th_percentile":12590.11,"90th_percentile":12590.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 8 Urology and Related Services","code_information":[{"code":"5378","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6484.09,"10th_percentile":6484.09,"90th_percentile":6484.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":18476.09,"10th_percentile":18476.09,"90th_percentile":18476.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":19510.76,"10th_percentile":19510.76,"90th_percentile":19510.76,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dialysis","code_information":[{"code":"5401","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2732.79,"10th_percentile":2581.07,"90th_percentile":5491.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":13969.4,"10th_percentile":13969.4,"90th_percentile":13969.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2489.11,"10th_percentile":2489.11,"90th_percentile":2489.11,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2355.2,"10th_percentile":2355.2,"90th_percentile":2355.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":2565.75,"10th_percentile":2457.95,"90th_percentile":7847.01,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":2526.52,"10th_percentile":2526.52,"90th_percentile":2526.52},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2542.05,"10th_percentile":2542.05,"90th_percentile":2542.05,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":50395.8,"10th_percentile":50395.8,"90th_percentile":50395.8},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2576.22,"10th_percentile":2576.22,"90th_percentile":2576.22,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Gynecologic Procedures","code_information":[{"code":"5411","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1011.94,"10th_percentile":557.02,"90th_percentile":3358.91},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":522.16,"10th_percentile":522.16,"90th_percentile":522.16,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":413.91,"10th_percentile":112.14,"90th_percentile":541.81,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"566","median_amount":1229.04,"10th_percentile":681.04,"90th_percentile":1690.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":957.86,"10th_percentile":957.86,"90th_percentile":1277.14},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":558.98,"10th_percentile":548.04,"90th_percentile":1742.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":285.52,"10th_percentile":160.64,"90th_percentile":388.57,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":981.17,"10th_percentile":508.72,"90th_percentile":1095.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":1136.65,"10th_percentile":1083.23,"90th_percentile":1292.02,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":288.43,"10th_percentile":288.43,"90th_percentile":288.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"130","median_amount":413.91,"10th_percentile":402.0,"90th_percentile":836.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"37","median_amount":308.32,"10th_percentile":154.0,"90th_percentile":368.08,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1525.24,"10th_percentile":1386.4,"90th_percentile":1564.11},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":261.04,"10th_percentile":261.04,"90th_percentile":261.04,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"25","median_amount":1760.4,"10th_percentile":365.54,"90th_percentile":4207.92},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"60","median_amount":548.04,"10th_percentile":484.18,"90th_percentile":643.93,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"79","median_amount":406.47,"10th_percentile":402.0,"90th_percentile":554.76,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":61.12,"10th_percentile":55.0,"90th_percentile":120.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"52","median_amount":36.09,"10th_percentile":33.19,"90th_percentile":99.99,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"63","median_amount":2129.06,"10th_percentile":1265.0,"90th_percentile":4146.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"105","median_amount":429.97,"10th_percentile":402.0,"90th_percentile":615.62,"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 ($): FEE SCHEDULE]","count":"23","median_amount":308.5,"10th_percentile":173.04,"90th_percentile":418.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":643.93,"10th_percentile":609.97,"90th_percentile":643.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"654","median_amount":414.65,"10th_percentile":410.04,"90th_percentile":553.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":155.96,"10th_percentile":113.38,"90th_percentile":312.22,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"11","median_amount":456.89,"10th_percentile":228.44,"90th_percentile":604.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Gynecologic Procedures","code_information":[{"code":"5412","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":39338.02,"10th_percentile":39338.02,"90th_percentile":39338.02},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"26","median_amount":225.75,"10th_percentile":118.05,"90th_percentile":1211.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":400.14,"10th_percentile":400.14,"90th_percentile":400.14,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":349.95,"10th_percentile":349.95,"90th_percentile":1450.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"90","median_amount":760.12,"10th_percentile":404.2,"90th_percentile":4399.07,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":772.97,"10th_percentile":772.97,"90th_percentile":772.97},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":720.06,"10th_percentile":720.06,"90th_percentile":720.06,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":4051.21,"10th_percentile":4051.21,"90th_percentile":4051.21,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":802.63,"10th_percentile":802.63,"90th_percentile":802.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":420.0,"10th_percentile":420.0,"90th_percentile":420.0,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":336.15,"10th_percentile":220.86,"90th_percentile":460.54,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":299.27,"10th_percentile":299.27,"90th_percentile":299.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":737.84,"10th_percentile":737.84,"90th_percentile":737.84,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":182.83,"10th_percentile":182.83,"90th_percentile":182.83,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":1354.5,"10th_percentile":1023.84,"90th_percentile":2077.2},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":865.59,"10th_percentile":288.5,"90th_percentile":1060.52,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":319.05,"10th_percentile":118.05,"90th_percentile":1391.85,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":105.05,"10th_percentile":68.73,"90th_percentile":388.58,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":1593.48,"10th_percentile":1593.48,"90th_percentile":1593.48},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"13","median_amount":1267.5,"10th_percentile":859.0,"90th_percentile":5182.27},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":381.04,"10th_percentile":240.6,"90th_percentile":1407.9,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":401.33,"10th_percentile":401.33,"90th_percentile":401.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"46","median_amount":210.28,"10th_percentile":120.41,"90th_percentile":1336.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":0.77,"10th_percentile":0.77,"90th_percentile":0.77,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2010.78,"10th_percentile":2010.78,"90th_percentile":2170.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Gynecologic Procedures","code_information":[{"code":"5413","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":2210.4,"10th_percentile":2210.4,"90th_percentile":2210.4},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"13","median_amount":1018.42,"10th_percentile":551.37,"90th_percentile":2230.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":969.36,"10th_percentile":969.36,"90th_percentile":969.36,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":645.62,"10th_percentile":534.15,"90th_percentile":1518.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":852.58,"10th_percentile":378.28,"90th_percentile":974.13,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":3209.4,"10th_percentile":3209.4,"90th_percentile":3209.4},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":691.11,"10th_percentile":691.11,"90th_percentile":691.11,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":534.9,"10th_percentile":534.9,"90th_percentile":534.9,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":100.0,"10th_percentile":100.0,"90th_percentile":100.0,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":47.99,"10th_percentile":47.99,"90th_percentile":47.99,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":1414.03,"10th_percentile":1124.0,"90th_percentile":2607.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2969.23,"10th_percentile":2969.23,"90th_percentile":2969.23,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":846.76,"10th_percentile":774.92,"90th_percentile":1235.6,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":545.6,"10th_percentile":500.03,"90th_percentile":654.69,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":175.92,"10th_percentile":175.92,"90th_percentile":175.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1205.4,"10th_percentile":1205.4,"90th_percentile":1205.4,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":10072.89,"10th_percentile":10072.89,"90th_percentile":10072.89},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2205.11,"10th_percentile":2205.11,"90th_percentile":2737.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"97","median_amount":5956.54,"10th_percentile":3837.07,"90th_percentile":9025.85,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":5032.83,"10th_percentile":5032.83,"90th_percentile":5032.83},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3133.47,"10th_percentile":2472.32,"90th_percentile":3264.75,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2655.71,"10th_percentile":2593.51,"90th_percentile":2938.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":2735.19,"10th_percentile":2735.19,"90th_percentile":2735.19,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3528.37,"10th_percentile":3528.37,"90th_percentile":3528.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1950.77,"10th_percentile":1588.02,"90th_percentile":3139.64,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":2801.45,"10th_percentile":2497.98,"90th_percentile":3067.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":897.32,"10th_percentile":886.37,"90th_percentile":1142.98,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":8026.35,"10th_percentile":3265.16,"90th_percentile":12293.27},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":2776.55,"10th_percentile":1835.65,"90th_percentile":4050.21,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":2693.98,"10th_percentile":2509.07,"90th_percentile":3087.37,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"53","median_amount":2040.31,"10th_percentile":1646.17,"90th_percentile":3294.86,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2787.08,"10th_percentile":2713.58,"90th_percentile":2839.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3109.02,"10th_percentile":2854.34,"90th_percentile":3897.69,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1987.85,"10th_percentile":755.1,"90th_percentile":3264.75,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4882.91,"10th_percentile":4882.91,"90th_percentile":4882.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"21","median_amount":7113.05,"10th_percentile":3815.39,"90th_percentile":9712.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6135.8,"10th_percentile":6135.8,"90th_percentile":6135.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4505.49,"10th_percentile":4422.4,"90th_percentile":4775.02,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":8447.65,"10th_percentile":8447.65,"90th_percentile":8447.65},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":6222.45,"10th_percentile":6222.45,"90th_percentile":6222.45},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":48.19,"10th_percentile":48.19,"90th_percentile":48.19,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2046.02,"10th_percentile":2046.02,"90th_percentile":2046.02,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":7404.33,"10th_percentile":7404.33,"90th_percentile":11256.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3434.51,"10th_percentile":3434.51,"90th_percentile":3434.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4683.15,"10th_percentile":4683.15,"90th_percentile":4683.15,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"20","median_amount":3356.59,"10th_percentile":2223.01,"90th_percentile":4008.36,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4783.6,"10th_percentile":4783.6,"90th_percentile":4783.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2855.57,"10th_percentile":2855.57,"90th_percentile":2855.57,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1854.23,"10th_percentile":1854.23,"90th_percentile":1854.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":4782.85,"10th_percentile":4046.26,"90th_percentile":6099.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":1513.85,"10th_percentile":1309.2,"90th_percentile":1892.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":8043.86,"10th_percentile":8043.86,"90th_percentile":8043.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1893.85,"10th_percentile":1549.31,"90th_percentile":1899.31,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1705.31,"10th_percentile":1588.0,"90th_percentile":4844.17,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1524.8,"10th_percentile":1524.8,"90th_percentile":1524.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1351.64,"10th_percentile":1351.64,"90th_percentile":1351.64,"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."}]}]},{"description":"Level 2 Nerve Procedures","code_information":[{"code":"5432","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2754.96,"10th_percentile":2754.96,"90th_percentile":2754.96,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"38","median_amount":1610.1,"10th_percentile":914.4,"90th_percentile":2420.11},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":904.42,"10th_percentile":678.53,"90th_percentile":904.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":434.55,"10th_percentile":210.9,"90th_percentile":649.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1449","median_amount":951.68,"10th_percentile":490.58,"90th_percentile":1649.16,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"16","median_amount":987.53,"10th_percentile":577.92,"90th_percentile":1697.7},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":718.49,"10th_percentile":577.92,"90th_percentile":748.59,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"670","median_amount":413.5,"10th_percentile":352.82,"90th_percentile":596.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"38","median_amount":444.77,"10th_percentile":241.39,"90th_percentile":1070.47,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"11","median_amount":951.63,"10th_percentile":120.25,"90th_percentile":1559.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":573.33,"10th_percentile":423.24,"90th_percentile":771.54,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"184","median_amount":384.3,"10th_percentile":262.8,"90th_percentile":563.98,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1481","median_amount":387.49,"10th_percentile":124.88,"90th_percentile":856.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1015.9,"10th_percentile":593.21,"90th_percentile":1327.05,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1253.0,"10th_percentile":220.4,"90th_percentile":4878.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":718.49,"10th_percentile":718.49,"90th_percentile":718.49,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"60","median_amount":1074.84,"10th_percentile":184.5,"90th_percentile":2404.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"34","median_amount":577.92,"10th_percentile":554.69,"90th_percentile":850.82,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"99","median_amount":314.85,"10th_percentile":262.5,"90th_percentile":611.1,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":563.37,"10th_percentile":556.27,"90th_percentile":707.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":1907.84,"10th_percentile":1907.84,"90th_percentile":2709.69},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":141.46,"10th_percentile":126.25,"90th_percentile":174.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":329.82,"10th_percentile":235.15,"90th_percentile":330.31,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"67","median_amount":74.26,"10th_percentile":49.26,"90th_percentile":102.89,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":1351.14,"10th_percentile":1328.04,"90th_percentile":1702.26},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"142","median_amount":1304.25,"10th_percentile":523.71,"90th_percentile":2568.48},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"101","median_amount":383.1,"10th_percentile":262.35,"90th_percentile":577.9,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1032","median_amount":414.07,"10th_percentile":142.5,"90th_percentile":768.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":554.69,"10th_percentile":554.69,"90th_percentile":554.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"816","median_amount":366.9,"10th_percentile":264.39,"90th_percentile":556.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"386","median_amount":330.29,"10th_percentile":116.93,"90th_percentile":622.67,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"90","median_amount":470.93,"10th_percentile":204.32,"90th_percentile":803.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Nerve Injections","code_information":[{"code":"5442","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":839.46,"10th_percentile":839.46,"90th_percentile":839.46},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":893.76,"10th_percentile":170.89,"90th_percentile":1050.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":671.24,"10th_percentile":426.08,"90th_percentile":2575.88,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1216.54,"10th_percentile":1216.54,"90th_percentile":1216.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"33","median_amount":3328.18,"10th_percentile":585.14,"90th_percentile":6379.44,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":4137.78,"10th_percentile":4137.78,"90th_percentile":4137.78},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3222.04,"10th_percentile":3222.04,"90th_percentile":3222.04,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1953.97,"10th_percentile":303.57,"90th_percentile":4294.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":5051.97,"10th_percentile":5051.97,"90th_percentile":5051.97,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":3835.43,"10th_percentile":3835.43,"90th_percentile":3835.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":586.2,"10th_percentile":476.25,"90th_percentile":933.4,"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 ($): FEE SCHEDULE]","count":"64","median_amount":644.23,"10th_percentile":239.87,"90th_percentile":3391.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":2628.77,"10th_percentile":2628.77,"90th_percentile":6587.83},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":943.1,"10th_percentile":943.1,"90th_percentile":3090.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":689.34,"10th_percentile":689.34,"90th_percentile":689.34,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":19326.07,"10th_percentile":19326.07,"90th_percentile":19326.07},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1168.4,"10th_percentile":948.12,"90th_percentile":2937.86,"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 ($): FEE SCHEDULE]","count":"48","median_amount":671.08,"10th_percentile":328.08,"90th_percentile":2330.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"43","median_amount":969.47,"10th_percentile":174.32,"90th_percentile":2205.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3207.31,"10th_percentile":628.11,"90th_percentile":3845.29,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1341.99,"10th_percentile":571.87,"90th_percentile":2511.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Nerve Injections","code_information":[{"code":"5443","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":8840.93,"10th_percentile":8840.93,"90th_percentile":8840.93},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4099.3,"10th_percentile":1116.99,"90th_percentile":13250.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"42","median_amount":1356.32,"10th_percentile":1100.46,"90th_percentile":5538.02,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3785.3,"10th_percentile":3785.3,"90th_percentile":3785.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"44","median_amount":3724.85,"10th_percentile":1032.71,"90th_percentile":11788.22,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6477.23,"10th_percentile":1361.81,"90th_percentile":6930.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":13250.97,"10th_percentile":13250.97,"90th_percentile":13250.97,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"156","median_amount":1418.97,"10th_percentile":987.77,"90th_percentile":6478.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":7571.71,"10th_percentile":7571.71,"90th_percentile":8121.58},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3267.3,"10th_percentile":3267.3,"90th_percentile":3267.3,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3850.2,"10th_percentile":3850.2,"90th_percentile":3850.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":18627.76,"10th_percentile":18627.76,"90th_percentile":18627.76},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":16977.2,"10th_percentile":3961.88,"90th_percentile":29242.18},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"88","median_amount":1420.14,"10th_percentile":1149.49,"90th_percentile":1637.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5852.74,"10th_percentile":5852.74,"90th_percentile":6309.55,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9889.32,"10th_percentile":9889.32,"90th_percentile":9889.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Neurostimulator and Related Procedures","code_information":[{"code":"5461","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":1936.0,"10th_percentile":1936.0,"90th_percentile":1936.0,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5992.18,"10th_percentile":5992.18,"90th_percentile":5992.18,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6363.71,"10th_percentile":6363.71,"90th_percentile":6363.71,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8583.27,"10th_percentile":8583.27,"90th_percentile":8583.27,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":5085.6,"10th_percentile":5085.6,"90th_percentile":5085.6,"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":"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."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8715.57,"10th_percentile":8715.57,"90th_percentile":8715.57,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16624.3,"10th_percentile":16624.3,"90th_percentile":16624.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":6944.44,"10th_percentile":6944.44,"90th_percentile":14490.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16624.3,"10th_percentile":16624.3,"90th_percentile":16624.3,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laser Eye Procedures","code_information":[{"code":"5481","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1698.5,"10th_percentile":1698.5,"90th_percentile":1698.5},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":183.97,"10th_percentile":183.97,"90th_percentile":183.97,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":622.19,"10th_percentile":525.8,"90th_percentile":657.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":973.18,"10th_percentile":973.18,"90th_percentile":973.18,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":493.29,"10th_percentile":73.39,"90th_percentile":661.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":346.8,"10th_percentile":346.8,"90th_percentile":346.8,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1571.55,"10th_percentile":1571.55,"90th_percentile":1571.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":180.74,"10th_percentile":180.74,"90th_percentile":180.74,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":569.76,"10th_percentile":569.76,"90th_percentile":569.76},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"14","median_amount":532.05,"10th_percentile":504.77,"90th_percentile":657.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":384.95,"10th_percentile":341.04,"90th_percentile":384.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":231.8,"10th_percentile":231.8,"90th_percentile":659.17,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":937.84,"10th_percentile":937.84,"90th_percentile":937.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Intraocular Procedures","code_information":[{"code":"5491","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":9742.93,"10th_percentile":9742.93,"90th_percentile":9742.93},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1106.33,"10th_percentile":1106.33,"90th_percentile":1106.33,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"58","median_amount":3792.66,"10th_percentile":1648.27,"90th_percentile":4761.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":5529.99,"10th_percentile":5529.99,"90th_percentile":5529.99},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3548.15,"10th_percentile":3548.15,"90th_percentile":3575.02,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3118.94,"10th_percentile":3118.94,"90th_percentile":3118.94,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":1228.06,"10th_percentile":1133.2,"90th_percentile":1468.54,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"288","median_amount":2109.69,"10th_percentile":1744.61,"90th_percentile":2219.61,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1341.6,"10th_percentile":1228.54,"90th_percentile":3330.55,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":3150.99,"10th_percentile":3150.99,"90th_percentile":3625.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1153.74,"10th_percentile":1152.54,"90th_percentile":2379.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"164","median_amount":2121.7,"10th_percentile":1768.09,"90th_percentile":2217.11,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"57","median_amount":1295.74,"10th_percentile":1164.34,"90th_percentile":1513.85,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"101","median_amount":1942.61,"10th_percentile":1768.09,"90th_percentile":2217.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"12","median_amount":3157.29,"10th_percentile":1914.81,"90th_percentile":3157.29,"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."}]}]},{"description":"Level 2 Intraocular Procedures","code_information":[{"code":"5492","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":13864.28,"10th_percentile":13864.28,"90th_percentile":13864.28},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":9002.08,"10th_percentile":8615.23,"90th_percentile":10668.46,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3692.84,"10th_percentile":3581.56,"90th_percentile":3905.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3147.15,"10th_percentile":3147.15,"90th_percentile":3147.15,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":3545.49,"10th_percentile":3271.96,"90th_percentile":3906.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":8076.94,"10th_percentile":8076.94,"90th_percentile":8076.94},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2895.18,"10th_percentile":2895.18,"90th_percentile":2897.01,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":3587.2,"10th_percentile":3129.29,"90th_percentile":3898.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2835.39,"10th_percentile":2193.42,"90th_percentile":3235.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3530.79,"10th_percentile":3133.28,"90th_percentile":3905.8,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5254.05,"10th_percentile":5254.05,"90th_percentile":5254.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Intraocular Procedures","code_information":[{"code":"5493","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2845.08,"10th_percentile":2845.08,"90th_percentile":2845.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4999.94,"10th_percentile":4999.94,"90th_percentile":4999.94,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":10734.5,"10th_percentile":10734.5,"90th_percentile":10984.33,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4632.44,"10th_percentile":4632.44,"90th_percentile":4632.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":4743.21,"10th_percentile":4743.21,"90th_percentile":4743.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2859.75,"10th_percentile":2859.75,"90th_percentile":2859.75,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4999.94,"10th_percentile":4603.74,"90th_percentile":5006.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":11374.63,"10th_percentile":11374.63,"90th_percentile":11374.63},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4733.94,"10th_percentile":4733.94,"90th_percentile":4733.94,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4616.77,"10th_percentile":4616.77,"90th_percentile":5004.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3037.7,"10th_percentile":3037.7,"90th_percentile":3545.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4681.44,"10th_percentile":4681.44,"90th_percentile":4681.44,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6759.45,"10th_percentile":6759.45,"90th_percentile":6759.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Extraocular, Repair, and Plastic Eye Procedures","code_information":[{"code":"5501","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":231.74,"10th_percentile":231.74,"90th_percentile":231.74,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":771.94,"10th_percentile":661.55,"90th_percentile":1314.06,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2801.6,"10th_percentile":2801.6,"90th_percentile":2801.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":154.88,"10th_percentile":124.88,"90th_percentile":415.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":885.33,"10th_percentile":885.33,"90th_percentile":885.33},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":268.5,"10th_percentile":268.5,"90th_percentile":268.5,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":420.47,"10th_percentile":417.61,"90th_percentile":420.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): 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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Extraocular, Repair, and Plastic Eye Procedures","code_information":[{"code":"5502","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":945.41,"10th_percentile":644.56,"90th_percentile":1069.56,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":793.95,"10th_percentile":679.46,"90th_percentile":1072.05,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":644.28,"10th_percentile":572.53,"90th_percentile":2232.98,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":946.06,"10th_percentile":946.06,"90th_percentile":946.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Extraocular, Repair, and Plastic Eye Procedures","code_information":[{"code":"5503","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1286.93,"10th_percentile":1286.93,"90th_percentile":1286.93,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2015.72,"10th_percentile":1844.29,"90th_percentile":2250.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":5021.11,"10th_percentile":4195.4,"90th_percentile":7134.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":2260.72,"10th_percentile":1893.22,"90th_percentile":2268.22,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3127.55,"10th_percentile":3127.55,"90th_percentile":3127.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2146.67,"10th_percentile":2146.67,"90th_percentile":2223.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":2262.57,"10th_percentile":1795.22,"90th_percentile":2270.22,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":9248.39,"10th_percentile":9248.39,"90th_percentile":9248.39},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":6637.99,"10th_percentile":6637.99,"90th_percentile":6637.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":8110.8,"10th_percentile":8110.8,"90th_percentile":8110.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":2226.16,"10th_percentile":1824.63,"90th_percentile":2267.73,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1387.32,"10th_percentile":1178.56,"90th_percentile":2604.46,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2193.46,"10th_percentile":1819.79,"90th_percentile":2268.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Extraocular, Repair, and Plastic Eye Procedures","code_information":[{"code":"5504","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3527.93,"10th_percentile":3527.93,"90th_percentile":3527.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3286.73,"10th_percentile":3286.73,"90th_percentile":3286.73,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Imaging without Contrast","code_information":[{"code":"5521","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"43","median_amount":597.41,"10th_percentile":400.0,"90th_percentile":2058.45},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"562","median_amount":125.55,"10th_percentile":78.75,"90th_percentile":491.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"265","median_amount":85.67,"10th_percentile":62.81,"90th_percentile":191.54,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"27","median_amount":139.3,"10th_percentile":134.21,"90th_percentile":309.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"33","median_amount":152.1,"10th_percentile":97.8,"90th_percentile":520.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1521","median_amount":381.09,"10th_percentile":146.39,"90th_percentile":681.03,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":490.48,"10th_percentile":206.1,"90th_percentile":517.16},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":225.13,"10th_percentile":177.07,"90th_percentile":1944.69,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"323","median_amount":85.82,"10th_percentile":35.0,"90th_percentile":184.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"37","median_amount":262.93,"10th_percentile":95.53,"90th_percentile":476.49,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"18","median_amount":381.09,"10th_percentile":180.35,"90th_percentile":1027.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":126.24,"10th_percentile":66.08,"90th_percentile":283.41,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"276","median_amount":153.75,"10th_percentile":97.8,"90th_percentile":483.3,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"818","median_amount":87.06,"10th_percentile":52.38,"90th_percentile":189.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":122.15,"10th_percentile":97.5,"90th_percentile":217.61,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":393.5,"10th_percentile":393.5,"90th_percentile":459.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":133.53,"10th_percentile":133.53,"90th_percentile":729.41,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"90","median_amount":377.52,"10th_percentile":107.65,"90th_percentile":1320.3},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"30","median_amount":122.06,"10th_percentile":73.47,"90th_percentile":652.13,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"182","median_amount":168.6,"10th_percentile":85.2,"90th_percentile":617.53,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":134.32,"10th_percentile":42.25,"90th_percentile":235.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":191.54,"10th_percentile":191.54,"90th_percentile":191.54,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":65.72,"10th_percentile":20.43,"90th_percentile":237.52,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":798.42,"10th_percentile":166.32,"90th_percentile":2734.83},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"143","median_amount":501.76,"10th_percentile":128.85,"90th_percentile":1747.74},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"170","median_amount":165.75,"10th_percentile":83.7,"90th_percentile":665.14,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"592","median_amount":85.67,"10th_percentile":60.82,"90th_percentile":191.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":150.09,"10th_percentile":150.09,"90th_percentile":150.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1231","median_amount":149.17,"10th_percentile":90.12,"90th_percentile":530.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"324","median_amount":85.32,"10th_percentile":36.32,"90th_percentile":175.95,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"83","median_amount":121.88,"10th_percentile":60.94,"90th_percentile":273.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Imaging without Contrast","code_information":[{"code":"5522","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"83","median_amount":912.11,"10th_percentile":382.68,"90th_percentile":2196.08},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"37","median_amount":168.24,"10th_percentile":162.37,"90th_percentile":336.48,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"48","median_amount":209.41,"10th_percentile":55.65,"90th_percentile":421.8,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"2488","median_amount":567.53,"10th_percentile":150.0,"90th_percentile":1444.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"16","median_amount":409.88,"10th_percentile":182.83,"90th_percentile":1632.73},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"29","median_amount":150.09,"10th_percentile":103.91,"90th_percentile":225.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"606","median_amount":103.05,"10th_percentile":19.64,"90th_percentile":105.15,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"55","median_amount":230.54,"10th_percentile":60.35,"90th_percentile":610.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"29","median_amount":429.09,"10th_percentile":50.0,"90th_percentile":1852.91,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":147.15,"10th_percentile":110.36,"90th_percentile":152.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":103.05,"10th_percentile":103.05,"90th_percentile":103.05},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"461","median_amount":190.95,"10th_percentile":43.35,"90th_percentile":501.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1669","median_amount":103.05,"10th_percentile":78.55,"90th_percentile":134.43,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":262.7,"10th_percentile":147.21,"90th_percentile":424.3,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1406.0,"10th_percentile":371.0,"90th_percentile":2591.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":218.24,"10th_percentile":146.7,"90th_percentile":435.61,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"139","median_amount":691.2,"10th_percentile":126.18,"90th_percentile":3097.35},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"72","median_amount":218.24,"10th_percentile":140.68,"90th_percentile":395.7,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"291","median_amount":190.05,"10th_percentile":83.7,"90th_percentile":432.3,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":103.47,"10th_percentile":103.47,"90th_percentile":103.47,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"25","median_amount":52.7,"10th_percentile":37.5,"90th_percentile":124.76,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":82.44,"10th_percentile":82.44,"90th_percentile":103.47,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"90","median_amount":53.43,"10th_percentile":37.5,"90th_percentile":116.21,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":816.06,"10th_percentile":234.36,"90th_percentile":2653.56},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"226","median_amount":683.52,"10th_percentile":165.73,"90th_percentile":1901.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"303","median_amount":190.95,"10th_percentile":89.65,"90th_percentile":470.87,"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":"1061","median_amount":103.05,"10th_percentile":82.44,"90th_percentile":124.89,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1782","median_amount":194.77,"10th_percentile":90.88,"90th_percentile":457.78,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"511","median_amount":103.05,"10th_percentile":29.55,"90th_percentile":105.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"141","median_amount":147.21,"10th_percentile":73.6,"90th_percentile":248.28,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"37","median_amount":2920.88,"10th_percentile":920.4,"90th_percentile":3605.78},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"20","median_amount":382.43,"10th_percentile":382.43,"90th_percentile":854.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":627.9,"10th_percentile":177.0,"90th_percentile":1067.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1307","median_amount":1719.42,"10th_percentile":485.87,"90th_percentile":2515.77,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":1674.65,"10th_percentile":859.48,"90th_percentile":2525.47},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":330.04,"10th_percentile":330.04,"90th_percentile":495.06,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"456","median_amount":222.56,"10th_percentile":64.86,"90th_percentile":319.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"27","median_amount":974.19,"10th_percentile":222.87,"90th_percentile":1675.0,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"16","median_amount":1928.0,"10th_percentile":684.83,"90th_percentile":2565.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":258.88,"10th_percentile":258.88,"90th_percentile":258.88,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"231","median_amount":627.9,"10th_percentile":153.3,"90th_percentile":1166.25,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1101","median_amount":234.23,"10th_percentile":87.48,"90th_percentile":359.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":516.23,"10th_percentile":267.69,"90th_percentile":597.54,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":2918.25,"10th_percentile":2918.25,"90th_percentile":2918.25},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":471.41,"10th_percentile":471.41,"90th_percentile":471.41,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"79","median_amount":1945.5,"10th_percentile":205.05,"90th_percentile":4596.3},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"30","median_amount":330.04,"10th_percentile":227.39,"90th_percentile":528.99,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"125","median_amount":670.74,"10th_percentile":177.0,"90th_percentile":908.53,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":398.92,"10th_percentile":398.92,"90th_percentile":398.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":334.62,"10th_percentile":334.62,"90th_percentile":334.62},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":124.77,"10th_percentile":81.21,"90th_percentile":339.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":187.39,"10th_percentile":187.39,"90th_percentile":187.39,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"57","median_amount":90.69,"10th_percentile":67.92,"90th_percentile":135.75,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":1879.5,"10th_percentile":680.4,"90th_percentile":5274.36},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"132","median_amount":2237.5,"10th_percentile":473.0,"90th_percentile":3348.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"171","median_amount":627.9,"10th_percentile":141.9,"90th_percentile":846.75,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"815","median_amount":232.9,"10th_percentile":48.03,"90th_percentile":360.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":330.04,"10th_percentile":330.04,"90th_percentile":330.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"956","median_amount":640.46,"10th_percentile":180.54,"90th_percentile":863.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"345","median_amount":234.23,"10th_percentile":87.84,"90th_percentile":360.58,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"71","median_amount":316.65,"10th_percentile":167.3,"90th_percentile":401.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Imaging without Contrast","code_information":[{"code":"5524","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"13","median_amount":3088.39,"10th_percentile":2659.4,"90th_percentile":3230.04},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"185","median_amount":620.29,"10th_percentile":567.65,"90th_percentile":1118.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"131","median_amount":531.32,"10th_percentile":275.4,"90th_percentile":749.85,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":867.47,"10th_percentile":867.47,"90th_percentile":867.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":607.95,"10th_percentile":607.95,"90th_percentile":1128.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"586","median_amount":2081.62,"10th_percentile":945.02,"90th_percentile":3117.06,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":2440.61,"10th_percentile":2440.61,"90th_percentile":2440.61},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":646.27,"10th_percentile":646.27,"90th_percentile":646.27,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"284","median_amount":428.24,"10th_percentile":163.83,"90th_percentile":563.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"20","median_amount":1040.81,"10th_percentile":105.38,"90th_percentile":12448.21,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":2081.62,"10th_percentile":2000.02,"90th_percentile":23698.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":738.35,"10th_percentile":738.35,"90th_percentile":738.35,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"109","median_amount":650.85,"10th_percentile":607.95,"90th_percentile":1128.45,"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 ($): FEE SCHEDULE]","count":"685","median_amount":479.06,"10th_percentile":198.6,"90th_percentile":656.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1339.17,"10th_percentile":1339.17,"90th_percentile":1339.17,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":2188.5,"10th_percentile":1782.28,"90th_percentile":3709.77},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":620.29,"10th_percentile":620.29,"90th_percentile":620.29,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"25","median_amount":3335.27,"10th_percentile":610.69,"90th_percentile":7163.1},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"26","median_amount":646.27,"10th_percentile":620.29,"90th_percentile":1218.25,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"50","median_amount":651.0,"10th_percentile":607.95,"90th_percentile":1249.2,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":533.5,"10th_percentile":533.5,"90th_percentile":533.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":139.07,"10th_percentile":128.43,"90th_percentile":283.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":425.07,"10th_percentile":425.07,"90th_percentile":425.07,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":80.39,"10th_percentile":80.39,"90th_percentile":133.55,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":1702.26,"10th_percentile":1702.26,"90th_percentile":2099.58},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"75","median_amount":2026.5,"10th_percentile":1570.76,"90th_percentile":3610.88},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"85","median_amount":607.95,"10th_percentile":607.95,"90th_percentile":1188.6,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"403","median_amount":510.08,"10th_percentile":198.45,"90th_percentile":656.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":646.27,"10th_percentile":646.27,"90th_percentile":646.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"380","median_amount":663.87,"10th_percentile":620.11,"90th_percentile":1200.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"183","median_amount":500.03,"10th_percentile":198.44,"90th_percentile":692.06,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"26","median_amount":350.12,"10th_percentile":175.05,"90th_percentile":759.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Imaging with Contrast","code_information":[{"code":"5571","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"15","median_amount":3254.51,"10th_percentile":2135.12,"90th_percentile":9803.14},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":365.05,"10th_percentile":365.05,"90th_percentile":365.05,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":524.4,"10th_percentile":188.4,"90th_percentile":1320.23,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"475","median_amount":1903.4,"10th_percentile":516.06,"90th_percentile":5416.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":857.72,"10th_percentile":857.72,"90th_percentile":857.72},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":441.56,"10th_percentile":153.61,"90th_percentile":544.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"173","median_amount":172.72,"10th_percentile":45.11,"90th_percentile":429.14,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"20","median_amount":1105.52,"10th_percentile":171.74,"90th_percentile":1901.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":2599.26,"10th_percentile":1344.41,"90th_percentile":4667.3,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":630.15,"10th_percentile":630.15,"90th_percentile":630.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"66","median_amount":567.15,"10th_percentile":195.3,"90th_percentile":2125.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"486","median_amount":172.72,"10th_percentile":103.14,"90th_percentile":428.14,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":3035.5,"10th_percentile":1771.0,"90th_percentile":3524.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":705.16,"10th_percentile":423.8,"90th_percentile":1563.4,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"26","median_amount":2050.6,"10th_percentile":203.51,"90th_percentile":11257.02},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":423.8,"10th_percentile":153.61,"90th_percentile":544.04,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"66","median_amount":894.45,"10th_percentile":198.15,"90th_percentile":2102.4,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":812.92,"10th_percentile":812.92,"90th_percentile":812.92,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":116.43,"10th_percentile":79.49,"90th_percentile":254.46,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":116.76,"10th_percentile":51.96,"90th_percentile":789.18,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":4420.08,"10th_percentile":4420.08,"90th_percentile":4420.08},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"51","median_amount":2385.2,"10th_percentile":502.4,"90th_percentile":4772.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"57","median_amount":706.2,"10th_percentile":166.95,"90th_percentile":2376.15,"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":"[APC ($): FEE SCHEDULE]","count":"293","median_amount":173.21,"10th_percentile":148.01,"90th_percentile":423.37,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"295","median_amount":567.02,"10th_percentile":192.17,"90th_percentile":1892.48,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"148","median_amount":175.96,"10th_percentile":123.22,"90th_percentile":427.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"19","median_amount":246.44,"10th_percentile":160.19,"90th_percentile":602.35,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"30","median_amount":3652.41,"10th_percentile":1655.06,"90th_percentile":7533.13},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":565.01,"10th_percentile":565.01,"90th_percentile":565.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":772.2,"10th_percentile":676.95,"90th_percentile":1116.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"957","median_amount":1942.89,"10th_percentile":677.95,"90th_percentile":4409.46,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"14","median_amount":2697.68,"10th_percentile":1939.3,"90th_percentile":5077.96},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":555.0,"10th_percentile":532.68,"90th_percentile":762.97,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"232","median_amount":346.51,"10th_percentile":73.86,"90th_percentile":517.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"21","median_amount":1464.48,"10th_percentile":639.32,"90th_percentile":2539.5,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"15","median_amount":1942.89,"10th_percentile":1674.33,"90th_percentile":4574.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":514.72,"10th_percentile":472.05,"90th_percentile":691.63,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"129","median_amount":772.2,"10th_percentile":508.95,"90th_percentile":1630.8,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"734","median_amount":346.08,"10th_percentile":27.58,"90th_percentile":509.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1201.37,"10th_percentile":1201.37,"90th_percentile":3213.9,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":2574.0,"10th_percentile":660.0,"90th_percentile":3537.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1187.54,"10th_percentile":1187.54,"90th_percentile":1187.54,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"57","median_amount":3843.92,"10th_percentile":503.45,"90th_percentile":11186.93},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"31","median_amount":555.0,"10th_percentile":441.56,"90th_percentile":594.91,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"88","median_amount":772.2,"10th_percentile":458.4,"90th_percentile":1483.35,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":76.58,"10th_percentile":76.58,"90th_percentile":76.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":465.09,"10th_percentile":465.09,"90th_percentile":465.09},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":169.52,"10th_percentile":166.01,"90th_percentile":394.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"43","median_amount":153.92,"10th_percentile":137.01,"90th_percentile":347.8,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":4153.38,"10th_percentile":4153.38,"90th_percentile":4153.38},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"104","median_amount":3294.4,"10th_percentile":1016.8,"90th_percentile":5708.84},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"94","median_amount":772.2,"10th_percentile":535.2,"90th_percentile":1484.85,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"498","median_amount":346.36,"10th_percentile":159.88,"90th_percentile":642.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"558","median_amount":787.65,"10th_percentile":415.39,"90th_percentile":1513.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"205","median_amount":347.08,"10th_percentile":52.08,"90th_percentile":486.06,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"40","median_amount":494.4,"10th_percentile":247.2,"90th_percentile":1096.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Imaging with Contrast","code_information":[{"code":"5573","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":5967.98,"10th_percentile":5967.98,"90th_percentile":5967.98},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":1072.65,"10th_percentile":739.5,"90th_percentile":3429.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":768.72,"10th_percentile":657.8,"90th_percentile":2741.5,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"59","median_amount":3857.77,"10th_percentile":2146.85,"90th_percentile":5283.53,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3078.97,"10th_percentile":3078.97,"90th_percentile":3078.97,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":726.17,"10th_percentile":286.93,"90th_percentile":797.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":7555.99,"10th_percentile":7555.99,"90th_percentile":7555.99,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":2660.61,"10th_percentile":2660.61,"90th_percentile":2660.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":1408.35,"10th_percentile":1072.2,"90th_percentile":2180.55,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"77","median_amount":727.23,"10th_percentile":496.1,"90th_percentile":2457.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":937.46,"10th_percentile":937.46,"90th_percentile":937.46},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1408.35,"10th_percentile":1408.35,"90th_percentile":3201.5,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1005.97,"10th_percentile":1005.97,"90th_percentile":1005.97,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":3076.8,"10th_percentile":3076.8,"90th_percentile":3076.8},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":7511.2,"10th_percentile":4694.5,"90th_percentile":8544.32},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1461.9,"10th_percentile":1408.35,"90th_percentile":3295.48,"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 ($): FEE SCHEDULE]","count":"40","median_amount":724.67,"10th_percentile":281.57,"90th_percentile":846.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"29","median_amount":1436.52,"10th_percentile":1093.65,"90th_percentile":4231.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":768.67,"10th_percentile":692.1,"90th_percentile":2619.01,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1093.71,"10th_percentile":1093.71,"90th_percentile":1093.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Nuclear Medicine and Related Services","code_information":[{"code":"5591","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":4292.34,"10th_percentile":3523.24,"90th_percentile":4292.34},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"32","median_amount":661.05,"10th_percentile":437.4,"90th_percentile":886.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":389.38,"10th_percentile":243.88,"90th_percentile":391.38,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":452.48,"10th_percentile":452.48,"90th_percentile":452.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"88","median_amount":1727.75,"10th_percentile":1179.01,"90th_percentile":3104.98,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":3006.33,"10th_percentile":3006.33,"90th_percentile":3006.33},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":487.8,"10th_percentile":487.8,"90th_percentile":487.8,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"36","median_amount":353.82,"10th_percentile":21.88,"90th_percentile":396.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1446.55,"10th_percentile":774.64,"90th_percentile":2459.37,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":1896.49,"10th_percentile":1896.49,"90th_percentile":1896.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":844.95,"10th_percentile":515.93,"90th_percentile":1857.0,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"70","median_amount":379.08,"10th_percentile":30.59,"90th_percentile":397.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":993.29,"10th_percentile":993.29,"90th_percentile":993.29,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1719.75,"10th_percentile":1719.75,"90th_percentile":1719.75},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":2413.2,"10th_percentile":787.5,"90th_percentile":6274.8},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":487.8,"10th_percentile":487.8,"90th_percentile":487.8,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":522.9,"10th_percentile":452.48,"90th_percentile":844.95,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":177.19,"10th_percentile":177.19,"90th_percentile":177.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":390.97,"10th_percentile":390.97,"90th_percentile":390.97,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":144.36,"10th_percentile":121.32,"90th_percentile":615.58,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":1417.92,"10th_percentile":1206.6,"90th_percentile":4567.69},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":522.9,"10th_percentile":437.4,"90th_percentile":1149.3,"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 ($): FEE SCHEDULE]","count":"67","median_amount":389.39,"10th_percentile":193.39,"90th_percentile":586.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"53","median_amount":861.85,"10th_percentile":59.29,"90th_percentile":963.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":389.38,"10th_percentile":95.38,"90th_percentile":395.38,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"11","median_amount":556.26,"10th_percentile":278.13,"90th_percentile":556.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Nuclear Medicine and Related Services","code_information":[{"code":"5592","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":4628.39,"10th_percentile":4544.16,"90th_percentile":4628.39},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":911.1,"10th_percentile":628.8,"90th_percentile":961.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":523.72,"10th_percentile":423.6,"90th_percentile":523.72,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":851.6,"10th_percentile":851.6,"90th_percentile":851.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"74","median_amount":2495.72,"10th_percentile":1589.7,"90th_percentile":3176.27,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":2589.35,"10th_percentile":2589.35,"90th_percentile":2589.35},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":189.1,"10th_percentile":144.3,"90th_percentile":490.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1559.81,"10th_percentile":1559.81,"90th_percentile":1559.81,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":2503.54,"10th_percentile":2503.54,"90th_percentile":2503.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":961.8,"10th_percentile":911.1,"90th_percentile":1026.3,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":522.03,"10th_percentile":150.0,"90th_percentile":532.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":3173.04,"10th_percentile":3173.04,"90th_percentile":4774.95},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":593.55,"10th_percentile":593.55,"90th_percentile":593.55,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":663.75,"10th_percentile":663.75,"90th_percentile":911.1,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":221.08,"10th_percentile":221.08,"90th_percentile":221.08,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":2915.52,"10th_percentile":2115.5,"90th_percentile":5129.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":934.95,"10th_percentile":934.95,"90th_percentile":1168.49,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":513.89,"10th_percentile":489.33,"90th_percentile":623.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"46","median_amount":929.32,"10th_percentile":282.44,"90th_percentile":1046.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":523.73,"10th_percentile":303.48,"90th_percentile":528.6,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":745.15,"10th_percentile":614.75,"90th_percentile":869.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Nuclear Medicine and Related Services","code_information":[{"code":"5593","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":14096.86,"10th_percentile":11002.82,"90th_percentile":26148.78},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"66","median_amount":2167.02,"10th_percentile":503.11,"90th_percentile":4937.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"101","median_amount":1270.23,"10th_percentile":475.4,"90th_percentile":2457.78,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2065.39,"10th_percentile":2065.39,"90th_percentile":2065.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2167.01,"10th_percentile":2165.91,"90th_percentile":5321.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"268","median_amount":7107.59,"10th_percentile":4242.25,"90th_percentile":10065.1,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":9379.7,"10th_percentile":8201.55,"90th_percentile":14445.06},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1252.56,"10th_percentile":1202.19,"90th_percentile":1575.7,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"167","median_amount":1108.37,"10th_percentile":479.98,"90th_percentile":2072.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":3595.16,"10th_percentile":579.93,"90th_percentile":8666.32,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":16179.05,"10th_percentile":16179.05,"90th_percentile":16179.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2638.82,"10th_percentile":2638.82,"90th_percentile":2638.82,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"38","median_amount":2253.75,"10th_percentile":2156.67,"90th_percentile":4395.62,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"383","median_amount":1219.46,"10th_percentile":482.12,"90th_percentile":2291.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2581.66,"10th_percentile":2581.66,"90th_percentile":2581.66,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":7401.2,"10th_percentile":7401.2,"90th_percentile":7401.2},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"17","median_amount":2631.5,"10th_percentile":1084.33,"90th_percentile":15863.24},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1252.56,"10th_percentile":1202.19,"90th_percentile":4629.44,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":2254.47,"10th_percentile":1636.17,"90th_percentile":5208.84,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1231.91,"10th_percentile":1231.91,"90th_percentile":1231.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":442.74,"10th_percentile":425.1,"90th_percentile":1863.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":262.88,"10th_percentile":251.05,"90th_percentile":1022.24,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":6067.62,"10th_percentile":6067.62,"90th_percentile":6067.62},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"29","median_amount":9383.57,"10th_percentile":5984.91,"90th_percentile":32123.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":2255.52,"10th_percentile":2165.25,"90th_percentile":6155.64,"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 ($): FEE SCHEDULE]","count":"249","median_amount":1266.09,"10th_percentile":472.48,"90th_percentile":2491.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"83","median_amount":2220.86,"10th_percentile":1669.97,"90th_percentile":4892.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"93","median_amount":1232.97,"10th_percentile":474.41,"90th_percentile":2201.73,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1807.22,"10th_percentile":1222.76,"90th_percentile":3001.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Nuclear Medicine and Related Services","code_information":[{"code":"5594","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":9878.57,"10th_percentile":9878.57,"90th_percentile":9878.57},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"42","median_amount":1943.38,"10th_percentile":1608.55,"90th_percentile":2057.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"57","median_amount":1413.42,"10th_percentile":1266.42,"90th_percentile":1538.3,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2307.63,"10th_percentile":2307.63,"90th_percentile":2307.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1940.1,"10th_percentile":1940.1,"90th_percentile":1940.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"99","median_amount":6644.89,"10th_percentile":5315.91,"90th_percentile":7194.09,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":1875.03,"10th_percentile":1875.03,"90th_percentile":1875.03},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1921.25,"10th_percentile":1921.25,"90th_percentile":1921.25,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"172","median_amount":1413.42,"10th_percentile":1045.92,"90th_percentile":3052.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1996.72,"10th_percentile":1996.72,"90th_percentile":1996.72,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"31","median_amount":1943.38,"10th_percentile":1940.1,"90th_percentile":2057.38,"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 ($): FEE SCHEDULE]","count":"337","median_amount":1413.42,"10th_percentile":1094.92,"90th_percentile":3214.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":6862.0,"10th_percentile":6862.0,"90th_percentile":6862.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1844.0,"10th_percentile":1844.0,"90th_percentile":1844.0,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":10924.8,"10th_percentile":10924.8,"90th_percentile":46761.6},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1921.25,"10th_percentile":1921.25,"90th_percentile":1921.25,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":1940.1,"10th_percentile":1940.1,"90th_percentile":2054.1,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1415.52,"10th_percentile":1415.52,"90th_percentile":1415.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3005.77,"10th_percentile":2992.76,"90th_percentile":3189.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1266.42,"10th_percentile":1266.42,"90th_percentile":1266.42,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3008.72,"10th_percentile":3008.72,"90th_percentile":3008.72,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":5764.08,"10th_percentile":5764.08,"90th_percentile":5764.08},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"12","median_amount":9256.01,"10th_percentile":5793.51,"90th_percentile":10371.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1943.38,"10th_percentile":1427.98,"90th_percentile":2057.38,"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 ($): FEE SCHEDULE]","count":"145","median_amount":1416.31,"10th_percentile":1217.43,"90th_percentile":3567.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"73","median_amount":1982.25,"10th_percentile":1978.9,"90th_percentile":2098.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"103","median_amount":1413.42,"10th_percentile":1079.81,"90th_percentile":2826.84,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2019.18,"10th_percentile":2019.18,"90th_percentile":2019.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Therapeutic Radiation Treatment Preparation","code_information":[{"code":"5611","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":672.9,"10th_percentile":672.9,"90th_percentile":672.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":344.1,"10th_percentile":344.1,"90th_percentile":344.1,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":635.56,"10th_percentile":635.56,"90th_percentile":635.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Therapeutic Radiation Treatment Preparation","code_information":[{"code":"5612","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":7790.69,"10th_percentile":7790.69,"90th_percentile":7790.69},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9273.0,"10th_percentile":9273.0,"90th_percentile":9273.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":453.81,"10th_percentile":453.81,"90th_percentile":4990.78,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":5190.44,"10th_percentile":1082.17,"90th_percentile":23778.14,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":680.32,"10th_percentile":401.0,"90th_percentile":7005.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9293.55,"10th_percentile":8638.16,"90th_percentile":14233.02,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":712.36,"10th_percentile":355.02,"90th_percentile":6154.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2405.53,"10th_percentile":2405.53,"90th_percentile":2405.53,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":52492.0,"10th_percentile":52492.0,"90th_percentile":53450.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9385.32,"10th_percentile":9385.32,"90th_percentile":9385.32,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4347.86,"10th_percentile":4347.86,"90th_percentile":5395.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":6166.67,"10th_percentile":168.61,"90th_percentile":11309.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4720.58,"10th_percentile":4720.58,"90th_percentile":4720.58,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Therapeutic Radiation Treatment Preparation","code_information":[{"code":"5613","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4501.8,"10th_percentile":3910.5,"90th_percentile":6009.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3331.47,"10th_percentile":1984.04,"90th_percentile":4670.08,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"11","median_amount":11850.25,"10th_percentile":7984.87,"90th_percentile":21516.18,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3297.88,"10th_percentile":3297.88,"90th_percentile":3297.88,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":2070.74,"10th_percentile":681.53,"90th_percentile":4466.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3507.3,"10th_percentile":3507.3,"90th_percentile":4993.5,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":3395.66,"10th_percentile":1550.36,"90th_percentile":4930.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4442.7,"10th_percentile":4442.7,"90th_percentile":4442.7,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":206.76,"10th_percentile":206.76,"90th_percentile":1148.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":18577.8,"10th_percentile":18577.8,"90th_percentile":18577.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4108.35,"10th_percentile":4108.35,"90th_percentile":4108.35,"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 ($): FEE SCHEDULE]","count":"18","median_amount":2302.04,"10th_percentile":1937.97,"90th_percentile":3839.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":4614.31,"10th_percentile":1113.08,"90th_percentile":6846.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1937.95,"10th_percentile":124.88,"90th_percentile":4386.56,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Radiation Therapy","code_information":[{"code":"5622","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":2188.15,"10th_percentile":2188.15,"90th_percentile":2299.72},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":849.45,"10th_percentile":817.2,"90th_percentile":4439.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2244.54,"10th_percentile":640.94,"90th_percentile":9389.18,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1216.2,"10th_percentile":1216.2,"90th_percentile":1216.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"23","median_amount":19351.98,"10th_percentile":4939.89,"90th_percentile":40580.91,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3554.08,"10th_percentile":1251.55,"90th_percentile":4894.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"28","median_amount":1836.82,"10th_percentile":383.5,"90th_percentile":5755.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2149.35,"10th_percentile":706.8,"90th_percentile":5214.6,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":36086.4,"10th_percentile":36086.4,"90th_percentile":36086.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":4230.0,"10th_percentile":4230.0,"90th_percentile":4230.0,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":896.83,"10th_percentile":306.8,"90th_percentile":8033.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":2760.54,"10th_percentile":866.44,"90th_percentile":6939.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3076.56,"10th_percentile":3076.56,"90th_percentile":3076.56,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Radiation Therapy","code_information":[{"code":"5623","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":30167.59,"10th_percentile":2589.28,"90th_percentile":52555.98},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":2357.4,"10th_percentile":1084.71,"90th_percentile":7263.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":2357.4,"10th_percentile":448.45,"90th_percentile":8357.47,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":15891.18,"10th_percentile":15891.18,"90th_percentile":15891.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"30","median_amount":28292.87,"10th_percentile":2836.1,"90th_percentile":43513.72,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1195.97,"10th_percentile":770.86,"90th_percentile":8020.16,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":5734.2,"10th_percentile":1688.55,"90th_percentile":9829.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":7497.12,"10th_percentile":7497.12,"90th_percentile":7497.12,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":2222.24,"10th_percentile":2222.24,"90th_percentile":2222.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7204.75,"10th_percentile":7204.75,"90th_percentile":7204.75,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"27","median_amount":2265.21,"10th_percentile":561.84,"90th_percentile":9939.3,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"81","median_amount":4464.93,"10th_percentile":1187.7,"90th_percentile":10123.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":25230.6,"10th_percentile":25230.6,"90th_percentile":25230.6},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3007.41,"10th_percentile":628.32,"90th_percentile":12601.24,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3294.37,"10th_percentile":509.7,"90th_percentile":8601.3,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":942.9,"10th_percentile":279.54,"90th_percentile":2811.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":45538.0,"10th_percentile":29292.8,"90th_percentile":54316.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":34.79,"10th_percentile":34.79,"90th_percentile":34.79,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":5306.72,"10th_percentile":1810.35,"90th_percentile":11454.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"47","median_amount":3570.44,"10th_percentile":563.8,"90th_percentile":9008.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"39","median_amount":5928.68,"10th_percentile":999.83,"90th_percentile":10732.33,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10161.03,"10th_percentile":10161.03,"90th_percentile":10161.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Radiation Therapy","code_information":[{"code":"5624","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3818.47,"10th_percentile":3818.47,"90th_percentile":3818.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Radiation Therapy","code_information":[{"code":"5626","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7096.01,"10th_percentile":7096.01,"90th_percentile":10617.44,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8776.09,"10th_percentile":1589.04,"90th_percentile":9059.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7042.54,"10th_percentile":3887.83,"90th_percentile":10617.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8671.59,"10th_percentile":4968.55,"90th_percentile":11057.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1895.98,"10th_percentile":1895.98,"90th_percentile":2398.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6254.07,"10th_percentile":6254.07,"90th_percentile":10894.08,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 7 Radiation Therapy","code_information":[{"code":"5627","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7437.45,"10th_percentile":7437.45,"90th_percentile":7437.45,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6029.16,"10th_percentile":6029.16,"90th_percentile":6029.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9011.98,"10th_percentile":9011.98,"90th_percentile":9011.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":346.55,"10th_percentile":346.55,"90th_percentile":346.55},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"13","median_amount":24.27,"10th_percentile":18.05,"90th_percentile":247.9,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1327.69,"10th_percentile":1327.69,"90th_percentile":1327.69,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1734.48,"10th_percentile":1734.48,"90th_percentile":1734.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":21.68,"10th_percentile":21.68,"90th_percentile":21.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":34.35,"10th_percentile":34.35,"90th_percentile":59.91,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1129.59,"10th_percentile":1099.3,"90th_percentile":1432.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":10000.0,"10th_percentile":10000.0,"90th_percentile":10000.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":21.42,"10th_percentile":21.42,"90th_percentile":21.42,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":34.09,"10th_percentile":34.09,"90th_percentile":34.09,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":31.56,"10th_percentile":31.56,"90th_percentile":31.56,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":385.6,"10th_percentile":385.6,"90th_percentile":385.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1423.87,"10th_percentile":51.78,"90th_percentile":1427.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"16","median_amount":34.79,"10th_percentile":30.61,"90th_percentile":72.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Pathology","code_information":[{"code":"5672","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":415.81,"10th_percentile":415.81,"90th_percentile":415.81,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":472.53,"10th_percentile":472.53,"90th_percentile":565.71,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3580.29,"10th_percentile":3580.29,"90th_percentile":3580.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":276.21,"10th_percentile":276.21,"90th_percentile":276.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":1711.0,"10th_percentile":1711.0,"90th_percentile":1711.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":169.45,"10th_percentile":169.45,"90th_percentile":274.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":245.87,"10th_percentile":245.87,"90th_percentile":245.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6340.62,"10th_percentile":6340.62,"90th_percentile":6340.62,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Pathology","code_information":[{"code":"5673","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":222.76,"10th_percentile":73.3,"90th_percentile":731.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":475.4,"10th_percentile":475.4,"90th_percentile":475.4,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":202.75,"10th_percentile":202.75,"90th_percentile":202.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"21","median_amount":255.34,"10th_percentile":24.7,"90th_percentile":3820.91,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":1952.81,"10th_percentile":1952.81,"90th_percentile":1952.81},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":473.47,"10th_percentile":473.47,"90th_percentile":473.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":440.71,"10th_percentile":440.71,"90th_percentile":440.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":612.21,"10th_percentile":205.53,"90th_percentile":620.66,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":473.47,"10th_percentile":473.47,"90th_percentile":637.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":4124.7,"10th_percentile":4124.7,"90th_percentile":4124.7},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":428.53,"10th_percentile":428.53,"90th_percentile":428.53,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":142.26,"10th_percentile":142.26,"90th_percentile":142.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":550.57,"10th_percentile":550.57,"90th_percentile":550.57,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":336.5,"10th_percentile":336.5,"90th_percentile":336.5},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":640.32,"10th_percentile":640.32,"90th_percentile":640.32,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":609.73,"10th_percentile":355.7,"90th_percentile":2781.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"25","median_amount":525.65,"10th_percentile":298.48,"90th_percentile":2144.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":445.62,"10th_percentile":445.62,"90th_percentile":445.62,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Drug Administration","code_information":[{"code":"5691","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1455.42,"10th_percentile":711.7,"90th_percentile":10242.1},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"57","median_amount":2852.21,"10th_percentile":703.79,"90th_percentile":6211.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"51","median_amount":107.18,"10th_percentile":52.6,"90th_percentile":2565.74,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4087.61,"10th_percentile":4087.61,"90th_percentile":4087.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2722.21,"10th_percentile":2246.24,"90th_percentile":3324.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"143","median_amount":133.29,"10th_percentile":39.04,"90th_percentile":13580.24,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":153.35,"10th_percentile":153.35,"90th_percentile":192.13},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2379.7,"10th_percentile":2379.7,"90th_percentile":3325.7,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"93","median_amount":126.04,"10th_percentile":53.48,"90th_percentile":2553.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":63.57,"10th_percentile":63.57,"90th_percentile":63.57,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"75","median_amount":14.25,"10th_percentile":14.25,"90th_percentile":4205.83,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"257","median_amount":112.83,"10th_percentile":53.07,"90th_percentile":2641.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3128.05,"10th_percentile":3128.05,"90th_percentile":3128.05,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":23082.3,"10th_percentile":23082.3,"90th_percentile":23082.3},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1777.33,"10th_percentile":280.75,"90th_percentile":3118.8,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":3630.62,"10th_percentile":2064.37,"90th_percentile":8635.72,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1134.31,"10th_percentile":1134.31,"90th_percentile":1134.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1405.38,"10th_percentile":586.53,"90th_percentile":4118.55,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":18175.19,"10th_percentile":18175.19,"90th_percentile":20845.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":2998.36,"10th_percentile":292.44,"90th_percentile":6009.81,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"162","median_amount":56.95,"10th_percentile":16.7,"90th_percentile":2605.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"79","median_amount":3178.53,"10th_percentile":124.09,"90th_percentile":5880.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"97","median_amount":56.04,"10th_percentile":16.7,"90th_percentile":2568.25,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3665.35,"10th_percentile":245.95,"90th_percentile":3665.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Drug Administration","code_information":[{"code":"5692","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"105","median_amount":575.97,"10th_percentile":181.36,"90th_percentile":32404.81},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1342","median_amount":79.5,"10th_percentile":46.04,"90th_percentile":283.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"313","median_amount":94.94,"10th_percentile":42.23,"90th_percentile":328.32,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"37","median_amount":95.12,"10th_percentile":76.14,"90th_percentile":206.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"83","median_amount":81.78,"10th_percentile":49.03,"90th_percentile":318.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"2919","median_amount":78.07,"10th_percentile":19.0,"90th_percentile":261.38,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"12","median_amount":156.13,"10th_percentile":29.02,"90th_percentile":245.46},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":209.25,"10th_percentile":170.92,"90th_percentile":322.05,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"541","median_amount":68.96,"10th_percentile":44.66,"90th_percentile":356.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"38","median_amount":31.49,"10th_percentile":10.27,"90th_percentile":222.2,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"31","median_amount":93.48,"10th_percentile":19.0,"90th_percentile":528.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":176.91,"10th_percentile":66.08,"90th_percentile":244.08,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":180.57,"10th_percentile":180.57,"90th_percentile":180.57},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"558","median_amount":112.95,"10th_percentile":43.05,"90th_percentile":283.46,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1446","median_amount":109.04,"10th_percentile":45.77,"90th_percentile":1670.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1488.77,"10th_percentile":140.15,"90th_percentile":3838.2,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":403.0,"10th_percentile":403.0,"90th_percentile":1120.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":220.89,"10th_percentile":210.53,"90th_percentile":346.79,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"120","median_amount":355.68,"10th_percentile":69.3,"90th_percentile":1673.1},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"85","median_amount":220.89,"10th_percentile":152.43,"90th_percentile":407.0,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"378","median_amount":126.71,"10th_percentile":49.03,"90th_percentile":318.55,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":1977.32,"10th_percentile":1715.83,"90th_percentile":2167.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":111.13,"10th_percentile":31.54,"90th_percentile":398.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":99.9,"10th_percentile":99.9,"90th_percentile":99.9,"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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"72","median_amount":52.13,"10th_percentile":20.2,"90th_percentile":160.26,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":883.26,"10th_percentile":727.02,"90th_percentile":7252.56},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"310","median_amount":461.6,"10th_percentile":143.5,"90th_percentile":1730.07},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"457","median_amount":113.55,"10th_percentile":49.03,"90th_percentile":283.46,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"773","median_amount":104.52,"10th_percentile":44.66,"90th_percentile":2289.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":206.3,"10th_percentile":206.3,"90th_percentile":206.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"2452","median_amount":118.42,"10th_percentile":46.96,"90th_percentile":309.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"533","median_amount":82.78,"10th_percentile":43.15,"90th_percentile":1489.03,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"153","median_amount":92.98,"10th_percentile":37.7,"90th_percentile":310.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Drug Administration","code_information":[{"code":"5693","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":3566.68,"10th_percentile":3410.63,"90th_percentile":24803.1},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1047.36,"10th_percentile":316.54,"90th_percentile":58003.24,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":364.57,"10th_percentile":110.62,"90th_percentile":2616.4,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"717","median_amount":1573.16,"10th_percentile":134.56,"90th_percentile":16303.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":5371.81,"10th_percentile":5371.81,"90th_percentile":5371.81},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":1124.22,"10th_percentile":374.74,"90th_percentile":10880.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"297","median_amount":816.64,"10th_percentile":204.16,"90th_percentile":6465.49,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"33","median_amount":615.5,"10th_percentile":285.15,"90th_percentile":1370.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":13589.53,"10th_percentile":2168.57,"90th_percentile":68657.19,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":286.87,"10th_percentile":286.87,"90th_percentile":1147.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"137","median_amount":828.95,"10th_percentile":194.44,"90th_percentile":4395.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"619","median_amount":647.39,"10th_percentile":199.1,"90th_percentile":5894.68,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":2526.94,"10th_percentile":1494.1,"90th_percentile":171224.72},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":935.69,"10th_percentile":935.69,"90th_percentile":935.69,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"28","median_amount":2894.16,"10th_percentile":612.18,"90th_percentile":10306.42},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":749.48,"10th_percentile":390.44,"90th_percentile":1171.32,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"94","median_amount":931.51,"10th_percentile":145.14,"90th_percentile":3520.67,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":600.67,"10th_percentile":600.67,"90th_percentile":1204.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":244.04,"10th_percentile":62.68,"90th_percentile":526.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"17","median_amount":248.96,"10th_percentile":111.73,"90th_percentile":1481.56,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"73","median_amount":3848.4,"10th_percentile":860.79,"90th_percentile":34807.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"148","median_amount":799.67,"10th_percentile":205.03,"90th_percentile":4864.74,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"375","median_amount":728.46,"10th_percentile":163.33,"90th_percentile":4467.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"774","median_amount":843.97,"10th_percentile":224.24,"90th_percentile":4957.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"208","median_amount":679.4,"10th_percentile":166.5,"90th_percentile":4443.1,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"35","median_amount":533.94,"10th_percentile":145.83,"90th_percentile":1211.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Drug Administration","code_information":[{"code":"5694","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":13042.39,"10th_percentile":9856.84,"90th_percentile":37664.0},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"165","median_amount":6718.87,"10th_percentile":1232.26,"90th_percentile":13868.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"151","median_amount":12509.62,"10th_percentile":1293.41,"90th_percentile":23277.72,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6888.25,"10th_percentile":6888.25,"90th_percentile":8200.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":7277.1,"10th_percentile":1284.07,"90th_percentile":10152.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"321","median_amount":17518.95,"10th_percentile":4467.86,"90th_percentile":34220.64,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":20157.3,"10th_percentile":2058.72,"90th_percentile":31780.93},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"332","median_amount":10040.72,"10th_percentile":573.02,"90th_percentile":20677.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"21","median_amount":787.75,"10th_percentile":188.75,"90th_percentile":14204.08,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":24518.76,"10th_percentile":20963.63,"90th_percentile":42360.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3807.19,"10th_percentile":3807.19,"90th_percentile":3807.19,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"73","median_amount":7520.41,"10th_percentile":1927.26,"90th_percentile":15064.18,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"576","median_amount":5955.86,"10th_percentile":638.04,"90th_percentile":17417.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":3559.29,"10th_percentile":331.36,"90th_percentile":80789.4},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":9402.0,"10th_percentile":3964.14,"90th_percentile":10661.65,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"44","median_amount":7613.28,"10th_percentile":2166.76,"90th_percentile":13184.5,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":15030.14,"10th_percentile":15030.14,"90th_percentile":15648.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":12864.79,"10th_percentile":11792.06,"90th_percentile":23328.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2555.41,"10th_percentile":2547.66,"90th_percentile":15410.16,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"45","median_amount":23985.37,"10th_percentile":11393.97,"90th_percentile":70925.9},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"98","median_amount":4736.73,"10th_percentile":1796.76,"90th_percentile":12718.96,"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 ($): FEE SCHEDULE]","count":"244","median_amount":3125.48,"10th_percentile":624.62,"90th_percentile":16156.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"253","median_amount":6879.65,"10th_percentile":2240.02,"90th_percentile":14892.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"239","median_amount":10604.8,"10th_percentile":624.6,"90th_percentile":23277.72,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"35","median_amount":21484.64,"10th_percentile":1760.3,"90th_percentile":44188.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 1 Diagnostic Tests and Related Services","code_information":[{"code":"5721","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":648.46,"10th_percentile":380.91,"90th_percentile":1092.71},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"54","median_amount":118.2,"10th_percentile":33.82,"90th_percentile":150.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":121.29,"10th_percentile":99.76,"90th_percentile":151.62,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":278.55,"10th_percentile":278.55,"90th_percentile":278.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"168","median_amount":404.72,"10th_percentile":209.55,"90th_percentile":662.86,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":455.78,"10th_percentile":455.78,"90th_percentile":455.78},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":352.88,"10th_percentile":352.88,"90th_percentile":352.88,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"35","median_amount":151.62,"10th_percentile":58.52,"90th_percentile":292.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":344.04,"10th_percentile":344.04,"90th_percentile":520.5,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":404.72,"10th_percentile":404.72,"90th_percentile":404.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":194.06,"10th_percentile":194.06,"90th_percentile":194.06,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"29","median_amount":118.2,"10th_percentile":61.2,"90th_percentile":282.6,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"112","median_amount":151.62,"10th_percentile":141.3,"90th_percentile":181.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":709.2,"10th_percentile":709.2,"90th_percentile":1064.89},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":210.99,"10th_percentile":202.51,"90th_percentile":1963.37,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":118.2,"10th_percentile":118.2,"90th_percentile":1810.32,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":33.82,"10th_percentile":33.82,"90th_percentile":33.82,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"19","median_amount":326.4,"10th_percentile":33.82,"90th_percentile":753.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":118.2,"10th_percentile":118.2,"90th_percentile":305.25,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"49","median_amount":125.17,"10th_percentile":102.62,"90th_percentile":154.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"122","median_amount":120.56,"10th_percentile":66.4,"90th_percentile":238.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"30","median_amount":127.72,"10th_percentile":78.12,"90th_percentile":232.9,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":179.9,"10th_percentile":108.29,"90th_percentile":394.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Diagnostic Tests and Related Services","code_information":[{"code":"5722","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":2644.14,"10th_percentile":2115.31,"90th_percentile":4341.88},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"136","median_amount":235.25,"10th_percentile":98.4,"90th_percentile":593.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"88","median_amount":301.75,"10th_percentile":125.01,"90th_percentile":426.63,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":492.67,"10th_percentile":492.67,"90th_percentile":564.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":593.4,"10th_percentile":108.6,"90th_percentile":949.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"323","median_amount":1005.03,"10th_percentile":336.92,"90th_percentile":2031.8,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":818.55,"10th_percentile":741.0,"90th_percentile":2010.99},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":512.75,"10th_percentile":492.13,"90th_percentile":512.75,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"149","median_amount":297.99,"10th_percentile":114.6,"90th_percentile":385.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":676.07,"10th_percentile":178.53,"90th_percentile":1874.18,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":577.81,"10th_percentile":577.81,"90th_percentile":577.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"61","median_amount":286.95,"10th_percentile":108.6,"90th_percentile":593.4,"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 ($): FEE SCHEDULE]","count":"344","median_amount":301.76,"10th_percentile":152.97,"90th_percentile":426.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":713.87,"10th_percentile":713.87,"90th_percentile":775.96,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"12","median_amount":651.6,"10th_percentile":413.07,"90th_percentile":3560.4},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":254.9,"10th_percentile":184.64,"90th_percentile":512.75,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"66","median_amount":510.6,"10th_percentile":112.05,"90th_percentile":679.35,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":227.14,"10th_percentile":227.14,"90th_percentile":241.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":194.18,"10th_percentile":74.51,"90th_percentile":507.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"23","median_amount":97.65,"10th_percentile":71.38,"90th_percentile":216.57,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"40","median_amount":597.6,"10th_percentile":212.52,"90th_percentile":3164.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"61","median_amount":332.25,"10th_percentile":112.05,"90th_percentile":728.1,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"207","median_amount":296.29,"10th_percentile":113.16,"90th_percentile":418.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"370","median_amount":212.52,"10th_percentile":110.77,"90th_percentile":605.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"99","median_amount":301.76,"10th_percentile":112.7,"90th_percentile":403.5,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"30","median_amount":429.73,"10th_percentile":161.0,"90th_percentile":609.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Diagnostic Tests and Related Services","code_information":[{"code":"5723","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":586.43,"10th_percentile":586.43,"90th_percentile":586.43},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":144.3,"10th_percentile":144.3,"90th_percentile":288.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":192.81,"10th_percentile":153.62,"90th_percentile":515.17,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":313.52,"10th_percentile":313.52,"90th_percentile":313.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":144.3,"10th_percentile":144.3,"90th_percentile":144.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"65","median_amount":576.77,"10th_percentile":395.26,"90th_percentile":787.8,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":1037.09,"10th_percentile":1037.09,"90th_percentile":1037.09},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":225.79,"10th_percentile":225.79,"90th_percentile":235.25,"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":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":192.03,"10th_percentile":133.93,"90th_percentile":421.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":202.1,"10th_percentile":168.45,"90th_percentile":288.39,"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":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":474.67,"10th_percentile":474.67,"90th_percentile":494.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":168.45,"10th_percentile":144.3,"90th_percentile":225.0,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":192.03,"10th_percentile":192.03,"90th_percentile":514.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1994.14,"10th_percentile":1994.14,"90th_percentile":1994.14,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":225.79,"10th_percentile":225.79,"90th_percentile":225.79,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":576.77,"10th_percentile":576.77,"90th_percentile":1080.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":235.25,"10th_percentile":184.64,"90th_percentile":921.68,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":168.45,"10th_percentile":144.3,"90th_percentile":208.35,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":103.24,"10th_percentile":103.24,"90th_percentile":103.24,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":762.24,"10th_percentile":481.0,"90th_percentile":6906.3},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":208.35,"10th_percentile":168.45,"90th_percentile":863.55,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":192.81,"10th_percentile":171.82,"90th_percentile":490.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"63","median_amount":171.82,"10th_percentile":147.19,"90th_percentile":215.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":193.53,"10th_percentile":146.88,"90th_percentile":411.34,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":684.52,"10th_percentile":274.33,"90th_percentile":734.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Diagnostic Tests and Related Services","code_information":[{"code":"5724","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":5042.15,"10th_percentile":5042.15,"90th_percentile":5500.12},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"52","median_amount":3002.47,"10th_percentile":1982.5,"90th_percentile":3753.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":1983.36,"10th_percentile":1983.36,"90th_percentile":1983.36},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":892.78,"10th_percentile":843.78,"90th_percentile":985.88,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":1716.19,"10th_percentile":1716.19,"90th_percentile":1716.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":546.43,"10th_percentile":546.43,"90th_percentile":546.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":1002.45,"10th_percentile":992.55,"90th_percentile":1071.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"77","median_amount":954.27,"10th_percentile":788.7,"90th_percentile":992.38,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1126.72,"10th_percentile":1126.72,"90th_percentile":1126.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":1930.0,"10th_percentile":1930.0,"90th_percentile":1930.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1002.45,"10th_percentile":992.55,"90th_percentile":1224.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":962.08,"10th_percentile":962.08,"90th_percentile":962.08,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":325.98,"10th_percentile":325.98,"90th_percentile":325.98,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":4009.8,"10th_percentile":3341.5,"90th_percentile":5716.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":992.55,"10th_percentile":992.55,"90th_percentile":1002.45,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"48","median_amount":946.54,"10th_percentile":788.71,"90th_percentile":989.9,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"58","median_amount":1022.5,"10th_percentile":1012.4,"90th_percentile":1104.35,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":966.28,"10th_percentile":912.38,"90th_percentile":989.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1114.23,"10th_percentile":985.88,"90th_percentile":1408.4,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"15","median_amount":48.77,"10th_percentile":48.77,"90th_percentile":892.29},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"91","median_amount":75.75,"10th_percentile":7.41,"90th_percentile":118.8,"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":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":23.74,"10th_percentile":18.99,"90th_percentile":223.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":658.69,"10th_percentile":38.75,"90th_percentile":2092.32,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2215.04,"10th_percentile":2215.04,"90th_percentile":2215.04,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"386","median_amount":265.75,"10th_percentile":25.08,"90th_percentile":270.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":269.52,"10th_percentile":269.52,"90th_percentile":269.52},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23.17,"10th_percentile":23.17,"90th_percentile":152.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":118.68,"10th_percentile":23.74,"90th_percentile":545.92,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":129.68,"10th_percentile":44.13,"90th_percentile":437.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":259.37,"10th_percentile":259.37,"90th_percentile":506.82,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":39.85,"10th_percentile":39.85,"90th_percentile":39.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"44","median_amount":75.75,"10th_percentile":7.41,"90th_percentile":286.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"55","median_amount":103.98,"10th_percentile":23.74,"90th_percentile":822.77,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":253.0,"10th_percentile":253.0,"90th_percentile":1004.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"18","median_amount":454.5,"10th_percentile":57.6,"90th_percentile":1486.6},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":23.17,"10th_percentile":23.17,"90th_percentile":190.49,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"28","median_amount":75.9,"10th_percentile":7.41,"90th_percentile":244.26,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":77.47,"10th_percentile":6.37,"90th_percentile":299.85,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":212.52,"10th_percentile":212.52,"90th_percentile":212.52},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"26","median_amount":404.0,"10th_percentile":32.0,"90th_percentile":936.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":75.75,"10th_percentile":7.41,"90th_percentile":187.36,"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":"22","median_amount":23.74,"10th_percentile":23.74,"90th_percentile":23.74,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":152.85,"10th_percentile":152.85,"90th_percentile":152.85,"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":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"156","median_amount":77.27,"10th_percentile":7.56,"90th_percentile":184.14,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":45.3,"10th_percentile":23.74,"90th_percentile":381.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"17","median_amount":33.91,"10th_percentile":14.38,"90th_percentile":33.91,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":18676.8,"10th_percentile":18676.8,"90th_percentile":18676.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2571.84,"10th_percentile":2571.84,"90th_percentile":2571.84,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":217.93,"10th_percentile":202.31,"90th_percentile":568.14},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"156","median_amount":95.4,"10th_percentile":42.9,"90th_percentile":149.73,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"88","median_amount":119.98,"10th_percentile":46.04,"90th_percentile":125.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":107.37,"10th_percentile":107.37,"90th_percentile":107.37,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":112.59,"10th_percentile":95.4,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"162","median_amount":168.2,"10th_percentile":117.51,"90th_percentile":334.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":151.01,"10th_percentile":151.01,"90th_percentile":151.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"117","median_amount":119.57,"10th_percentile":45.18,"90th_percentile":125.39,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":93.65,"10th_percentile":93.65,"90th_percentile":93.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":326.65,"10th_percentile":326.65,"90th_percentile":326.65,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":85.17,"10th_percentile":85.17,"90th_percentile":85.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":124.88,"10th_percentile":124.88,"90th_percentile":124.88},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"43","median_amount":138.45,"10th_percentile":42.9,"90th_percentile":194.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"354","median_amount":124.88,"10th_percentile":46.05,"90th_percentile":127.43,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":82.24,"10th_percentile":82.24,"90th_percentile":82.24,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":175.0,"10th_percentile":175.0,"90th_percentile":175.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":68.25,"10th_percentile":68.25,"90th_percentile":68.25,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"12","median_amount":421.2,"10th_percentile":74.9,"90th_percentile":923.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":167.74,"10th_percentile":167.74,"90th_percentile":173.84,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"26","median_amount":59.93,"10th_percentile":42.9,"90th_percentile":138.6,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":325.19,"10th_percentile":325.19,"90th_percentile":325.19,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":37.18,"10th_percentile":4.17,"90th_percentile":166.83,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"18","median_amount":183.04,"10th_percentile":114.4,"90th_percentile":2112.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"30","median_amount":138.45,"10th_percentile":70.32,"90th_percentile":174.77,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"235","median_amount":124.88,"10th_percentile":55.27,"90th_percentile":124.99,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"230","median_amount":71.73,"10th_percentile":43.76,"90th_percentile":165.25,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"73","median_amount":100.38,"10th_percentile":47.41,"90th_percentile":127.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":178.4,"10th_percentile":82.24,"90th_percentile":178.4,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":2616.41,"10th_percentile":326.74,"90th_percentile":3643.88},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"119","median_amount":225.47,"10th_percentile":78.0,"90th_percentile":667.65,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"96","median_amount":124.91,"10th_percentile":42.11,"90th_percentile":125.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":203.94,"10th_percentile":203.94,"90th_percentile":10926.17,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":78.0,"10th_percentile":35.51,"90th_percentile":475.18,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"336","median_amount":300.0,"10th_percentile":100.0,"90th_percentile":2337.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":267.07,"10th_percentile":267.07,"90th_percentile":267.07},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":115.45,"10th_percentile":115.45,"90th_percentile":121.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"106","median_amount":124.88,"10th_percentile":90.61,"90th_percentile":125.61,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":255.25,"10th_percentile":255.25,"90th_percentile":3988.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":982.42,"10th_percentile":267.07,"90th_percentile":8690.5,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":170.97,"10th_percentile":170.97,"90th_percentile":170.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":7.31,"10th_percentile":7.31,"90th_percentile":7.31},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"63","median_amount":157.61,"10th_percentile":56.86,"90th_percentile":646.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"383","median_amount":124.91,"10th_percentile":47.6,"90th_percentile":127.01,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":254.9,"10th_percentile":254.9,"90th_percentile":254.9,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":131.2,"10th_percentile":131.2,"90th_percentile":131.2},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"14","median_amount":377.2,"10th_percentile":115.7,"90th_percentile":1825.14},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":116.35,"10th_percentile":47.62,"90th_percentile":707.03,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"21","median_amount":207.41,"10th_percentile":49.2,"90th_percentile":1606.74,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":865.83,"10th_percentile":865.83,"90th_percentile":865.83,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":186.86,"10th_percentile":160.78,"90th_percentile":1106.07,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":153.55,"10th_percentile":30.45,"90th_percentile":1106.07,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":1004.22,"10th_percentile":1004.22,"90th_percentile":1004.22},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"63","median_amount":585.0,"10th_percentile":196.0,"90th_percentile":3041.54},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"42","median_amount":233.26,"10th_percentile":73.91,"90th_percentile":590.91,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"218","median_amount":124.91,"10th_percentile":80.81,"90th_percentile":127.46,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"289","median_amount":264.36,"10th_percentile":79.56,"90th_percentile":681.01,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"111","median_amount":115.55,"10th_percentile":75.91,"90th_percentile":127.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"22","median_amount":178.4,"10th_percentile":66.14,"90th_percentile":178.44,"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."}]}]},{"description":"Level 5 Minor Procedures","code_information":[{"code":"5735","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":110.85,"10th_percentile":110.85,"90th_percentile":301.5,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":55.43,"10th_percentile":55.43,"90th_percentile":55.43,"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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":1223.01,"10th_percentile":379.55,"90th_percentile":1466.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":230.61,"10th_percentile":230.61,"90th_percentile":230.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":379.55,"10th_percentile":379.55,"90th_percentile":379.55,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":119.46,"10th_percentile":119.46,"90th_percentile":119.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":594.07,"10th_percentile":570.18,"90th_percentile":714.33,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":110.85,"10th_percentile":110.85,"90th_percentile":110.85,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":95.0,"10th_percentile":95.0,"90th_percentile":95.0,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":1037.0,"10th_percentile":1037.0,"90th_percentile":1037.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":110.85,"10th_percentile":110.85,"90th_percentile":310.11,"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":"Medicare 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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":113.22,"10th_percentile":113.07,"90th_percentile":591.79,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Electronic Analysis of Devices","code_information":[{"code":"5741","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":128.24,"10th_percentile":118.65,"90th_percentile":131.83},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"126","median_amount":25.95,"10th_percentile":18.3,"90th_percentile":48.77,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"233","median_amount":34.33,"10th_percentile":28.91,"90th_percentile":36.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":16.95,"10th_percentile":16.95,"90th_percentile":25.95,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"424","median_amount":64.07,"10th_percentile":48.85,"90th_percentile":88.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":60.31,"10th_percentile":30.16,"90th_percentile":92.33},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":55.97,"10th_percentile":49.44,"90th_percentile":55.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"515","median_amount":36.14,"10th_percentile":34.11,"90th_percentile":36.14,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"15","median_amount":29.02,"10th_percentile":23.22,"90th_percentile":75.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":88.85,"10th_percentile":88.85,"90th_percentile":98.21,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":49.47,"10th_percentile":49.47,"90th_percentile":53.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"69","median_amount":25.95,"10th_percentile":16.95,"90th_percentile":25.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"957","median_amount":36.14,"10th_percentile":28.91,"90th_percentile":36.88,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"42","median_amount":81.36,"10th_percentile":25.95,"90th_percentile":109.8},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"43","median_amount":53.72,"10th_percentile":47.45,"90th_percentile":55.97,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"24","median_amount":18.3,"10th_percentile":16.95,"90th_percentile":28.05,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":36.29,"10th_percentile":36.29,"90th_percentile":36.29,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":65.93,"10th_percentile":12.75,"90th_percentile":65.93,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"19","median_amount":48.77,"10th_percentile":12.75,"90th_percentile":49.47,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"70","median_amount":90.4,"10th_percentile":56.5,"90th_percentile":138.4},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"66","median_amount":25.95,"10th_percentile":16.95,"90th_percentile":51.76,"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":"703","median_amount":34.7,"10th_percentile":28.36,"90th_percentile":36.88,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"350","median_amount":17.29,"10th_percentile":17.29,"90th_percentile":26.47,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"198","median_amount":29.05,"10th_percentile":16.54,"90th_percentile":36.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"20","median_amount":51.63,"10th_percentile":48.73,"90th_percentile":51.63,"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."}]}]},{"description":"Level 2 Electronic Analysis of Devices","code_information":[{"code":"5742","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":87.29,"10th_percentile":87.29,"90th_percentile":87.29,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":289.16,"10th_percentile":289.16,"90th_percentile":289.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":89.35,"10th_percentile":89.35,"90th_percentile":89.35,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":48.39,"10th_percentile":48.39,"90th_percentile":48.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":32.84,"10th_percentile":32.84,"90th_percentile":32.84,"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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":42.42,"10th_percentile":42.42,"90th_percentile":42.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":86.14,"10th_percentile":86.14,"90th_percentile":190.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Rehabilitation","code_information":[{"code":"5771","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":43.05,"10th_percentile":32.19,"90th_percentile":408.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":854.07,"10th_percentile":854.07,"90th_percentile":854.07,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1561.2,"10th_percentile":1561.2,"90th_percentile":1561.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"38","median_amount":1428.56,"10th_percentile":349.24,"90th_percentile":2095.44,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":956.3,"10th_percentile":956.3,"90th_percentile":956.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"50","median_amount":785.49,"10th_percentile":237.54,"90th_percentile":1346.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":306.0,"10th_percentile":306.0,"90th_percentile":3060.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":78.88,"10th_percentile":78.88,"90th_percentile":115.27,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":2448.0,"10th_percentile":350.4,"90th_percentile":3264.0},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":510.0,"10th_percentile":153.0,"90th_percentile":888.19,"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 ($): FEE SCHEDULE]","count":"49","median_amount":717.78,"10th_percentile":122.11,"90th_percentile":1436.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":445.65,"10th_percentile":89.05,"90th_percentile":717.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1247.16,"10th_percentile":979.28,"90th_percentile":1263.81,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1292.76,"10th_percentile":1131.16,"90th_percentile":1440.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Resuscitation and Cardioversion","code_information":[{"code":"5781","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1109.35,"10th_percentile":750.12,"90th_percentile":1168.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":634.12,"10th_percentile":578.22,"90th_percentile":1165.44,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":548.37,"10th_percentile":548.37,"90th_percentile":548.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"21","median_amount":1463.47,"10th_percentile":932.37,"90th_percentile":6539.2,"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":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":641.62,"10th_percentile":381.02,"90th_percentile":2348.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":653.29,"10th_percentile":653.29,"90th_percentile":653.29,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3896.9,"10th_percentile":3896.9,"90th_percentile":3896.9,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"61","median_amount":634.62,"10th_percentile":528.84,"90th_percentile":1167.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1501.7,"10th_percentile":1501.7,"90th_percentile":1501.7,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":7716.33,"10th_percentile":7716.33,"90th_percentile":7716.33},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1343.09,"10th_percentile":1343.09,"90th_percentile":1343.09,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":639.0,"10th_percentile":639.0,"90th_percentile":639.0,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"34","median_amount":634.64,"10th_percentile":364.62,"90th_percentile":1176.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":533.65,"10th_percentile":488.65,"90th_percentile":3212.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":640.12,"10th_percentile":340.12,"90th_percentile":1036.28,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Treatment","code_information":[{"code":"5791","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"20","median_amount":414.75,"10th_percentile":160.35,"90th_percentile":874.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":192.93,"10th_percentile":192.93,"90th_percentile":192.93,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11303.48,"10th_percentile":11303.48,"90th_percentile":11303.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":111.9,"10th_percentile":111.9,"90th_percentile":111.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"31","median_amount":1232.05,"10th_percentile":336.34,"90th_percentile":2211.7,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":745.95,"10th_percentile":745.95,"90th_percentile":745.95,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":124.88,"10th_percentile":122.54,"90th_percentile":1082.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":329.36,"10th_percentile":111.9,"90th_percentile":706.28,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":201.11,"10th_percentile":124.88,"90th_percentile":537.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":3627.9,"10th_percentile":3627.9,"90th_percentile":3627.9},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":279.45,"10th_percentile":279.45,"90th_percentile":452.7,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":198.55,"10th_percentile":198.55,"90th_percentile":198.55,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":1477.6,"10th_percentile":671.0,"90th_percentile":7944.03},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":746.77,"10th_percentile":295.65,"90th_percentile":979.41,"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":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":150.4,"10th_percentile":131.12,"90th_percentile":412.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"36","median_amount":425.95,"10th_percentile":190.02,"90th_percentile":911.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":95.54,"10th_percentile":52.99,"90th_percentile":193.13,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1172.96,"10th_percentile":1172.96,"90th_percentile":1172.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Manipulation Therapy","code_information":[{"code":"5811","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":195.07,"10th_percentile":161.54,"90th_percentile":212.0},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"40","median_amount":31.8,"10th_percentile":31.8,"90th_percentile":38.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":24.62,"10th_percentile":19.62,"90th_percentile":124.88,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":40.03,"10th_percentile":40.03,"90th_percentile":40.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":118.07,"10th_percentile":118.07,"90th_percentile":118.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"277","median_amount":108.88,"10th_percentile":87.11,"90th_percentile":134.45,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"54","median_amount":24.55,"10th_percentile":9.34,"90th_percentile":46.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":92.56,"10th_percentile":92.56,"90th_percentile":92.56,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":131.48,"10th_percentile":131.48,"90th_percentile":138.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":33.26,"10th_percentile":33.26,"90th_percentile":33.26,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"32","median_amount":38.4,"10th_percentile":31.8,"90th_percentile":91.55,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"73","median_amount":24.55,"10th_percentile":8.95,"90th_percentile":46.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":102.4,"10th_percentile":84.8,"90th_percentile":128.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"12","median_amount":190.8,"10th_percentile":46.91,"90th_percentile":230.4},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":37.02,"10th_percentile":37.02,"90th_percentile":38.57,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":31.8,"10th_percentile":31.8,"90th_percentile":81.45,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":26.58,"10th_percentile":26.58,"90th_percentile":26.58},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":27.77,"10th_percentile":27.77,"90th_percentile":27.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"47","median_amount":169.6,"10th_percentile":76.0,"90th_percentile":204.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"11","median_amount":31.8,"10th_percentile":31.8,"90th_percentile":38.4,"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":"[APC ($): FEE SCHEDULE]","count":"135","median_amount":23.54,"10th_percentile":8.8,"90th_percentile":45.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"106","median_amount":32.44,"10th_percentile":32.44,"90th_percentile":39.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":23.95,"10th_percentile":9.19,"90th_percentile":99.9,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":169.61,"10th_percentile":169.61,"90th_percentile":169.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 2 Health and Behavior Services","code_information":[{"code":"5822","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"40","median_amount":547.12,"10th_percentile":162.31,"90th_percentile":1164.81},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"232","median_amount":107.7,"10th_percentile":31.95,"90th_percentile":259.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":107.55,"10th_percentile":89.63,"90th_percentile":338.35,"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":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":175.62,"10th_percentile":146.35,"90th_percentile":370.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"14","median_amount":107.7,"10th_percentile":31.95,"90th_percentile":107.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1654","median_amount":368.77,"10th_percentile":109.4,"90th_percentile":3615.73,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":383.2,"10th_percentile":116.23,"90th_percentile":388.2},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":182.83,"10th_percentile":146.7,"90th_percentile":190.49,"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":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"62","median_amount":89.64,"10th_percentile":80.63,"90th_percentile":210.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"36","median_amount":184.38,"10th_percentile":54.7,"90th_percentile":313.48,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"28","median_amount":368.77,"10th_percentile":109.4,"90th_percentile":410.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":159.16,"10th_percentile":159.16,"90th_percentile":167.75,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"113","median_amount":107.7,"10th_percentile":31.95,"90th_percentile":259.4,"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 ($): FEE SCHEDULE]","count":"258","median_amount":89.64,"10th_percentile":80.63,"90th_percentile":113.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":254.78,"10th_percentile":205.67,"90th_percentile":1475.83,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"14","median_amount":106.5,"10th_percentile":106.5,"90th_percentile":359.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":146.7,"10th_percentile":146.7,"90th_percentile":146.7,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"52","median_amount":191.7,"10th_percentile":118.91,"90th_percentile":646.2},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"36","median_amount":146.7,"10th_percentile":146.7,"90th_percentile":334.64,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"64","median_amount":107.7,"10th_percentile":31.95,"90th_percentile":178.65,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20.2,"10th_percentile":20.2,"90th_percentile":29.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":77.21,"10th_percentile":2.03,"90th_percentile":163.3,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":301.56,"10th_percentile":301.56,"90th_percentile":1487.22},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"160","median_amount":359.0,"10th_percentile":106.5,"90th_percentile":1348.5},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"61","median_amount":107.7,"10th_percentile":31.95,"90th_percentile":285.16,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"154","median_amount":89.65,"10th_percentile":87.96,"90th_percentile":113.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":146.7,"10th_percentile":146.7,"90th_percentile":232.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"458","median_amount":109.86,"10th_percentile":32.59,"90th_percentile":198.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"46","median_amount":89.64,"10th_percentile":89.64,"90th_percentile":129.59,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"50","median_amount":161.97,"10th_percentile":128.06,"90th_percentile":161.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Health and Behavior Services","code_information":[{"code":"5823","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"17","median_amount":275.08,"10th_percentile":275.08,"90th_percentile":291.08},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"67","median_amount":32.25,"10th_percentile":32.25,"90th_percentile":54.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":215.0,"10th_percentile":215.0,"90th_percentile":254.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":32.25,"10th_percentile":32.25,"90th_percentile":32.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"166","median_amount":148.33,"10th_percentile":90.34,"90th_percentile":370.82,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":95.98,"10th_percentile":93.87,"90th_percentile":251.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":290.71,"10th_percentile":290.71,"90th_percentile":290.71},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":290.47,"10th_percentile":290.47,"90th_percentile":290.47,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"22","median_amount":54.15,"10th_percentile":54.15,"90th_percentile":54.15,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":125.61,"10th_percentile":125.61,"90th_percentile":125.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":172.0,"10th_percentile":172.0,"90th_percentile":172.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj acetaminophen -fresenius","code_information":[{"code":"9143","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Leuprolide acetate suspnsion","code_information":[{"code":"9217","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, amisulpride, 1 mg","code_information":[{"code":"9247","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1671.08,"10th_percentile":1671.08,"90th_percentile":1671.08,"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":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, denosumab","code_information":[{"code":"9272","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1502.66,"10th_percentile":1502.66,"90th_percentile":1502.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Platelet pheres leukoreduced","code_information":[{"code":"9501","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":844.49,"10th_percentile":844.49,"90th_percentile":844.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":694.64,"10th_percentile":694.64,"90th_percentile":694.64,"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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"RBC leukocytes reduced","code_information":[{"code":"9512","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2475.99,"10th_percentile":2475.99,"90th_percentile":2475.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"1 through 10","median_amount":868.38,"10th_percentile":768.48,"90th_percentile":14200.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Plate pheres leukoredu irrad","code_information":[{"code":"9530","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":529.69,"10th_percentile":529.69,"90th_percentile":529.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":4560.56,"10th_percentile":4560.56,"90th_percentile":4560.56,"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":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3052.32,"10th_percentile":3052.32,"90th_percentile":18215.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"1 through 10","median_amount":2702.56,"10th_percentile":2702.56,"90th_percentile":6338.19,"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":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":851.55,"10th_percentile":851.55,"90th_percentile":851.55,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1154.78,"10th_percentile":1154.78,"90th_percentile":1154.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_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 ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Clinical Diagnostic Lab Services","code_information":[{"code":"N800","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"131","median_amount":781.28,"10th_percentile":144.47,"90th_percentile":2503.16},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"67","median_amount":59.22,"10th_percentile":13.38,"90th_percentile":173.23,"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":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"5139","median_amount":35.27,"10th_percentile":11.2,"90th_percentile":121.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"23","median_amount":22.73,"10th_percentile":5.0,"90th_percentile":125.0},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"25","median_amount":31.12,"10th_percentile":11.4,"90th_percentile":231.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1390","median_amount":49.51,"10th_percentile":16.52,"90th_percentile":149.72,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"149","median_amount":38.99,"10th_percentile":11.61,"90th_percentile":125.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"71","median_amount":28.42,"10th_percentile":8.25,"90th_percentile":178.3,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"34","median_amount":49.9,"10th_percentile":19.69,"90th_percentile":186.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"815","median_amount":60.11,"10th_percentile":23.33,"90th_percentile":215.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"3546","median_amount":55.14,"10th_percentile":16.92,"90th_percentile":149.72,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":74.2,"10th_percentile":34.13,"90th_percentile":582.3,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"23","median_amount":328.5,"10th_percentile":91.6,"90th_percentile":1272.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":61.2,"10th_percentile":61.2,"90th_percentile":73.79,"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":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"296","median_amount":215.52,"10th_percentile":13.38,"90th_percentile":1833.3},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"134","median_amount":19.75,"10th_percentile":8.53,"90th_percentile":69.61,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"445","median_amount":57.35,"10th_percentile":17.29,"90th_percentile":238.93,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":510.4,"10th_percentile":510.4,"90th_percentile":510.4,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":33.93,"10th_percentile":33.93,"90th_percentile":33.93},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"34","median_amount":53.82,"10th_percentile":16.55,"90th_percentile":329.18,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"108","median_amount":32.32,"10th_percentile":9.09,"90th_percentile":182.89,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"14","median_amount":394.8,"10th_percentile":126.84,"90th_percentile":664.02},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"545","median_amount":464.8,"10th_percentile":71.04,"90th_percentile":1782.8},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"496","median_amount":59.86,"10th_percentile":19.13,"90th_percentile":189.86,"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":"1907","median_amount":52.93,"10th_percentile":16.53,"90th_percentile":149.77,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":138.86,"10th_percentile":138.86,"90th_percentile":138.86,"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":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"3060","median_amount":51.53,"10th_percentile":14.67,"90th_percentile":185.85,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"908","median_amount":58.39,"10th_percentile":16.81,"90th_percentile":151.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"331","median_amount":67.5,"10th_percentile":13.0,"90th_percentile":244.17,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"28","median_amount":725.42,"10th_percentile":89.92,"90th_percentile":3525.04},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"778","median_amount":261.6,"10th_percentile":62.4,"90th_percentile":554.25,"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":"[APC ($): FEE SCHEDULE]","count":"127","median_amount":196.82,"10th_percentile":53.14,"90th_percentile":489.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"14","median_amount":388.8,"10th_percentile":154.76,"90th_percentile":475.43,"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":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"37","median_amount":234.9,"10th_percentile":38.7,"90th_percentile":655.5,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1243","median_amount":874.16,"10th_percentile":135.5,"90th_percentile":2779.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":824.03,"10th_percentile":824.03,"90th_percentile":824.03},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"15","median_amount":273.0,"10th_percentile":48.69,"90th_percentile":585.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"177","median_amount":144.89,"10th_percentile":55.99,"90th_percentile":438.69,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"13","median_amount":363.25,"10th_percentile":32.36,"90th_percentile":2570.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"15","median_amount":796.25,"10th_percentile":450.11,"90th_percentile":2465.25,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":137.9,"10th_percentile":137.9,"90th_percentile":137.9,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":388.47,"10th_percentile":388.47,"90th_percentile":388.47,"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":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"301","median_amount":236.4,"10th_percentile":62.4,"90th_percentile":579.0,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"352","median_amount":190.27,"10th_percentile":56.17,"90th_percentile":533.79,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":714.0,"10th_percentile":476.0,"90th_percentile":952.0},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"66","median_amount":860.88,"10th_percentile":234.64,"90th_percentile":3627.36},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"41","median_amount":284.11,"10th_percentile":70.1,"90th_percentile":893.25,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"130","median_amount":218.7,"10th_percentile":46.2,"90th_percentile":643.8,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":322.0,"10th_percentile":322.0,"90th_percentile":322.0,"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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":64.68,"10th_percentile":64.68,"90th_percentile":64.68,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":43.8,"10th_percentile":37.74,"90th_percentile":183.06,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"146","median_amount":1067.4,"10th_percentile":154.0,"90th_percentile":4705.6},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"199","median_amount":196.2,"10th_percentile":27.6,"90th_percentile":606.6,"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":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"221","median_amount":201.28,"10th_percentile":68.96,"90th_percentile":631.39,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1390","median_amount":272.96,"10th_percentile":47.12,"90th_percentile":627.93,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"96","median_amount":119.59,"10th_percentile":60.89,"90th_percentile":338.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"52","median_amount":177.45,"10th_percentile":48.7,"90th_percentile":432.9,"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."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"40","median_amount":330.71,"10th_percentile":330.71,"90th_percentile":349.75},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"204","median_amount":65.1,"10th_percentile":65.1,"90th_percentile":72.0,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"169","median_amount":97.03,"10th_percentile":97.03,"90th_percentile":99.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"11","median_amount":148.52,"10th_percentile":148.52,"90th_percentile":152.85,"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":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"13","median_amount":65.1,"10th_percentile":65.1,"90th_percentile":82.05,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1625","median_amount":222.9,"10th_percentile":222.9,"90th_percentile":241.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"1 through 10","median_amount":250.48,"10th_percentile":231.63,"90th_percentile":250.48},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":92.86,"10th_percentile":92.86,"90th_percentile":96.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"298","median_amount":97.03,"10th_percentile":97.03,"90th_percentile":99.86,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"54","median_amount":140.47,"10th_percentile":111.45,"90th_percentile":204.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"29","median_amount":222.9,"10th_percentile":222.9,"90th_percentile":241.07,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":147.76,"10th_percentile":147.76,"90th_percentile":147.76,"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":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":157.17,"10th_percentile":157.17,"90th_percentile":157.17,"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":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"1 through 10","median_amount":97.03,"10th_percentile":97.03,"90th_percentile":97.03},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"113","median_amount":65.1,"10th_percentile":65.1,"90th_percentile":68.85,"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":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"807","median_amount":97.03,"10th_percentile":97.03,"90th_percentile":99.86,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":398.12,"10th_percentile":397.75,"90th_percentile":408.22,"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":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"1 through 10","median_amount":217.0,"10th_percentile":217.0,"90th_percentile":273.5},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"49","median_amount":390.6,"10th_percentile":122.28,"90th_percentile":413.1},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":92.86,"10th_percentile":92.86,"90th_percentile":96.75,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"60","median_amount":65.1,"10th_percentile":65.1,"90th_percentile":68.85,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":74.08,"10th_percentile":74.08,"90th_percentile":101.23,"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":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"12","median_amount":74.08,"10th_percentile":73.78,"90th_percentile":74.08,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"1 through 10","median_amount":182.28,"10th_percentile":164.22,"90th_percentile":243.18},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"140","median_amount":273.5,"10th_percentile":217.0,"90th_percentile":367.2},{"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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"72","median_amount":65.1,"10th_percentile":65.1,"90th_percentile":68.85,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"440","median_amount":97.04,"10th_percentile":97.03,"90th_percentile":99.87,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"416","median_amount":66.4,"10th_percentile":66.4,"90th_percentile":70.23,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"223","median_amount":97.03,"10th_percentile":97.03,"90th_percentile":99.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"93","median_amount":138.62,"10th_percentile":138.62,"90th_percentile":142.66,"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."}]}]},{"description":"Durable Medical Equipment","code_information":[{"code":"N805","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":276.74,"10th_percentile":170.97,"90th_percentile":420.0,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":159.94,"10th_percentile":143.47,"90th_percentile":358.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":280.0,"10th_percentile":280.0,"90th_percentile":280.0,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"22","median_amount":147.06,"10th_percentile":55.47,"90th_percentile":287.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":288.69,"10th_percentile":93.9,"90th_percentile":1134.4,"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":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"1 through 10","median_amount":179.42,"10th_percentile":179.42,"90th_percentile":179.42,"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":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":401.39,"10th_percentile":280.0,"90th_percentile":527.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":242.06,"10th_percentile":152.1,"90th_percentile":607.71,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":176.79,"10th_percentile":176.79,"90th_percentile":176.79,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":3508.78,"10th_percentile":3508.78,"90th_percentile":3508.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":977.24,"10th_percentile":977.24,"90th_percentile":977.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":275.52,"10th_percentile":82.39,"90th_percentile":602.86,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":302.37,"10th_percentile":64.0,"90th_percentile":964.85,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":170.0,"10th_percentile":170.0,"90th_percentile":274.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32.0,"10th_percentile":32.0,"90th_percentile":32.0,"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."}]}]},{"description":"Pharmacy Services","code_information":[{"code":"N806","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":10.1,"10th_percentile":10.1,"90th_percentile":10.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Medicine","code_information":[{"code":"N809","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10.35,"10th_percentile":10.35,"90th_percentile":10.35,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"34","median_amount":36.24,"10th_percentile":29.0,"90th_percentile":36.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":29.36,"10th_percentile":29.36,"90th_percentile":29.36,"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":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":30.39,"10th_percentile":29.17,"90th_percentile":31.01,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":15.58,"10th_percentile":15.58,"90th_percentile":15.58,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10.35,"10th_percentile":10.35,"90th_percentile":10.35,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare 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":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":31.01,"10th_percentile":31.01,"90th_percentile":31.01,"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":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10.35,"10th_percentile":10.35,"90th_percentile":10.35,"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":30.39,"10th_percentile":30.39,"90th_percentile":30.39,"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":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"40","median_amount":10.56,"10th_percentile":10.56,"90th_percentile":10.56,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":30.39,"10th_percentile":30.39,"90th_percentile":30.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":1332.74,"10th_percentile":1332.74,"90th_percentile":1332.74},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"18","median_amount":1093.56,"10th_percentile":926.93,"90th_percentile":1093.71,"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":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1001.76,"10th_percentile":1001.76,"90th_percentile":1093.56,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"28","median_amount":3748.25,"10th_percentile":805.32,"90th_percentile":3799.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1093.56,"10th_percentile":261.21,"90th_percentile":1093.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":965.77,"10th_percentile":965.77,"90th_percentile":965.77,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1093.56,"10th_percentile":1093.56,"90th_percentile":1093.56,"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":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":1061.26,"10th_percentile":1061.26,"90th_percentile":1061.26,"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":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":3649.0,"10th_percentile":1155.0,"90th_percentile":3957.89},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":965.83,"10th_percentile":243.81,"90th_percentile":1093.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"20","median_amount":1115.43,"10th_percentile":266.28,"90th_percentile":1115.58,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Packaged Services","code_information":[{"code":"N902","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"1 through 10","median_amount":365.76,"10th_percentile":365.76,"90th_percentile":365.76},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":10.02,"10th_percentile":10.02,"90th_percentile":10.02,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"29","median_amount":13.52,"10th_percentile":10.82,"90th_percentile":1102.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12.8,"10th_percentile":12.8,"90th_percentile":12.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"1 through 10","median_amount":36.0,"10th_percentile":36.0,"90th_percentile":36.0},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12.8,"10th_percentile":12.8,"90th_percentile":12.8,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":12.89,"10th_percentile":12.89,"90th_percentile":75.31,"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":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"1 through 10","median_amount":416.8,"10th_percentile":179.2,"90th_percentile":459.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient 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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Implant DME","code_information":[{"code":"N906","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":495.0,"10th_percentile":495.0,"90th_percentile":495.0,"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":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":92.45,"10th_percentile":92.45,"90th_percentile":994.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Not Billable to FI","code_information":[{"code":"N907","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2.99,"10th_percentile":2.99,"90th_percentile":2.99,"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":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Pathology Fee Schedule: FEE SCHEDULE] [Occupational Therapy Fee Schedule: FEE SCHEDULE] [Physical Therapy Fee Schedule: FEE SCHEDULE] [Speech Therapy Fee Schedule: FEE SCHEDULE] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2.99,"10th_percentile":2.99,"90th_percentile":2.99,"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":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 51.36] [Observation (%BC): 51.36] [Emergency Department (%BC): 51.36] [MRI OP ($): 1928] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 51.36] [Physical Therapy (%BC): 51.36] [Respiratory Services/Therapy  (%BC): 51.36] [Speech Therapy (%BC): 51.36] [All Other OP (%BC): 51.36]","count":"1 through 10","median_amount":269.61,"10th_percentile":269.61,"90th_percentile":269.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":53.37,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 43.66] [Observation (%BC): 43.66] [Emergency Department (%BC): 43.66] [MRI OP ($): 1639] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 43.66] [Physical Therapy (%BC): 43.66] [Respiratory Services/Therapy  (%BC): 43.66] [Speech Therapy (%BC): 43.66] [All Other OP (%BC): 43.66]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 47.25] [Observation (%BC): 47.25] [Emergency Department (%BC): 47.25] [MRI OP ($): 1774] [Reference Lab Fee Schedule: FEE SCHEDULE] [Occupational Therapy (%BC): 47.25] [Physical Therapy (%BC): 47.25] [Respiratory Services/Therapy  (%BC): 47.25] [Speech Therapy (%BC): 47.25] [All Other OP (%BC): 47.25]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":43.38,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2.99,"10th_percentile":2.99,"90th_percentile":2.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":30.93,"10th_percentile":30.93,"90th_percentile":30.93,"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":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare 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":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":2.99,"10th_percentile":2.99,"90th_percentile":2.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":3.05,"10th_percentile":3.05,"90th_percentile":3.05,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complex Aortic Arch Procedures","code_information":[{"code":"209","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 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":20113.9,"10th_percentile":20113.9,"90th_percentile":20113.9,"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":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"1 through 10","median_amount":20064.78,"10th_percentile":20064.78,"90th_percentile":20064.78,"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":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":16539.84,"maximum":33079.68,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16539.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26463.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19847.81,"additional_payer_notes":"C-Section 3 day stay-Case Rate Days 3"},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16539.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"fee schedule","standard_charge_dollar":23982.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16539.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33079.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16539.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16539.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16870.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16539.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23155.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20674.8,"additional_payer_notes":"Psych-Case Rate"}]}]},{"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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: FEE SCHEDULE Days: 3] [Normal vag. Del. 2 day stay-Case Rate: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":50.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Magellan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":45.27,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":42.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":80.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY 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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":90.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"The Health Plan","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://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [Psych-Case 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":"percent of total billed charges","standard_charge_percentage":76.2,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","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: FEE SCHEDULE Days: 2]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 49.92] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","methodology":"percent of total billed charges","standard_charge_percentage":51.83,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 42.43] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 74564 | Total % of Charge: 45.93] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Caresource","plan_name":"OH Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"OH Medicaid 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":"Humana","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","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."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient physical therapy plan of care","code":"GP","modifier_payer_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"OH Medicaid 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":"Humana","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","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."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient occupational therapy plan of care","code":"GO","modifier_payer_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"OH Medicaid 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":"Humana","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","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."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient speech language pathology plan of care","code":"GN","modifier_payer_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"OH Medicaid 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":"Humana","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","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."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","description":"The modified price is presented in the standard charge value."}]},{"description":"Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the same day of the Procedure or Other Service","code":"25","modifier_payer_information":[{"payer_name":"BCBS","plan_name":"Anthem Blue Access/Preferred HMO/PPO/HIC","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway HPN PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Traditional Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Alliance Coal","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem - KY Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HealthKeepers Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Marketplace Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"OH Medicaid 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":"Humana","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"MCA 90 Degree Benefits","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MedCost","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"OH Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PHCS All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Optima","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Passport Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sentara Health Plans","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"The Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Unicare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Mine Workers of America","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","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."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"VA Premier","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Ambetter All Commercial Plans","description":"The modified price is presented in the standard charge value."}]}]}